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Telesca M, De Angelis A, Donniacuo M, Bellocchio G, Riemma MA, Mele E, Canonico F, Cianflone E, Torella D, D'Amario D, Patti G, Liantonio A, Imbrici P, De Luca A, Castaldo G, Rossi F, Cappetta D, Urbanek K, Berrino L. Effects of sacubitril-valsartan on aging-related cardiac dysfunction. Eur J Pharmacol 2024; 978:176794. [PMID: 38968980 DOI: 10.1016/j.ejphar.2024.176794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024]
Abstract
Heart failure (HF) remains a huge medical burden worldwide, with aging representing a major risk factor. Here, we report the effects of sacubitril/valsartan, an approved drug for HF with reduced EF, in an experimental model of aging-related HF with preserved ejection fraction (HFpEF). Eighteen-month-old female Fisher 344 rats were treated for 12 weeks with sacubitril/valsartan (60 mg/kg/day) or with valsartan (30 mg/kg/day). Three-month-old rats were used as control. No differential action of sacubitril/valsartan versus valsartan alone, either positive or negative, was observed. The positive effects of both sacubitril/valsartan and valsartan on cardiac hypertrophy was evidenced by a significant reduction of wall thickness and myocyte cross-sectional area. Contrarily, myocardial fibrosis in aging heart was not reduced by any treatment. Doppler echocardiography and left ventricular catheterization evidenced diastolic dysfunction in untreated and treated old rats. In aging rats, both classical and non-classical renin-angiotensin-aldosterone system (RAAS) were modulated. In particular, with respect to untreated animals, both sacubitril/valsartan and valsartan showed a partial restoration of cardioprotective non-classical RAAS. In conclusion, this study evidenced the favorable effects, by both treatments, on age-related cardiac hypertrophy. The attenuation of cardiomyocyte size and hypertrophic response may be linked to a shift towards cardioprotective RAAS signaling. However, diastolic dysfunction and cardiac fibrosis persisted despite of treatment and were accompanied by myocardial inflammation, endothelial activation, and oxidative stress.
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Affiliation(s)
- Marialucia Telesca
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138, Naples, Italy
| | - Antonella De Angelis
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138, Naples, Italy
| | - Maria Donniacuo
- Department of Experimental Medicine, University of Salento, Via Lecce-Monteroni, 73047, Lecce, Italy
| | - Gabriella Bellocchio
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138, Naples, Italy
| | - Maria Antonietta Riemma
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138, Naples, Italy
| | - Elena Mele
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138, Naples, Italy
| | - Francesco Canonico
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Eleonora Cianflone
- Department of Medical and Surgical Sciences, Magna Graecia University, Viale Europa, 88100, Catanzaro, Italy
| | - Daniele Torella
- Department of Experimental and Clinical Medicine, Magna Graecia University, 88100, Catanzaro, Italy
| | - Domenico D'Amario
- Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli, 17, 28100, Novara, Italy
| | - Giuseppe Patti
- Department of Translational Medicine, Università del Piemonte Orientale, via Solaroli, 17, 28100, Novara, Italy
| | - Antonella Liantonio
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125, Bari, Italy
| | - Paola Imbrici
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125, Bari, Italy
| | - Annamaria De Luca
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125, Bari, Italy
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via A. Pansini 5, 80131, Naples, Italy; CEINGE-Advanced Biotechnologies, Via G. Salvatore 486, 80131, Naples, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138, Naples, Italy
| | - Donato Cappetta
- Department of Experimental Medicine, University of Salento, Via Lecce-Monteroni, 73047, Lecce, Italy.
| | - Konrad Urbanek
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via A. Pansini 5, 80131, Naples, Italy; CEINGE-Advanced Biotechnologies, Via G. Salvatore 486, 80131, Naples, Italy
| | - Liberato Berrino
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138, Naples, Italy
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Saarinen SL, Borregaard B, Ekholm O, Christensen AV, Thorup CB, Thomsen T, Thrysoee L, Mols RE, Juel K, Berg SK, Rasmussen TB. Self-reported mental and physical health is associated with not returning to work in patients with ischemic heart disease. Int J Cardiol 2024; 409:132180. [PMID: 38759797 DOI: 10.1016/j.ijcard.2024.132180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Ischemic Heart Disease (IHD) can lead to prolonged sick leave and loss of ability to work. This study aimed to describe non-return to work (non-RTW) across three IHD subgroups at 3 and at 12 months post discharge, and explore whether baseline characteristics, and patient-reported mental and physical health were associated with work detachment. METHODS Data from the national cohort study DenHeart were used, including the patient-reported outcomes (PROs) Short-Form 12, Hospital Anxiety and Depression Scale, Edmonton Symptom Assessment Scale and HeartQoL measured at discharge and register-based follow-up at 3 and at 12 months. A total of 3873 patients with IHD ≤ 63 years old and part of the workforce prior to hospitalisation, were included in the analyses and divided into three groups: chronic IHD/stable angina, non-STEMI (non-ST-Elevation Myocardial Infarction)/unstable angina and STEMI (ST-Elevation Myocardial Infarction). A composite outcome of 'prolonged sick leave' and/or 'left the workforce' was defined as non-return to work (non-RTW). Adjusted logistic regression models were performed. RESULTS Overall, the frequency of non-RTW was 37.7% and 38.0% at 3 and 12 months, respectively, thus not improving with time. The largest proportion of non-RTW was found in STEMI patients, followed by non-STEMI/unstable angina and IHD/stable angina patients. Several clinical and socio-demographic factors, as well as patient-reported mental and physical health were associated with non-RTW among the subgroups. CONCLUSION The findings demonstrate a need for identifying IHD patients at risk of non-RTW after discharge based on their mental and physical health and a need for initiatives to minimize unwanted non-RTW.
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Affiliation(s)
- Stine Lise Saarinen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Charlotte Brun Thorup
- Department of Cardiology, Cardiothoracic surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Thordis Thomsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Acute, Critical and Emergency Care Science Unit, Department of Anaesthesiology, Herlev and Gentofte University Hospital, Herlev, Denmark
| | - Lars Thrysoee
- Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Rikke Elmose Mols
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Selina Kikkenborg Berg
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Trine Bernholdt Rasmussen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
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Lehnert K, Könemann S, Bahls M. Personalized nutritional prevention for Lp(a): PUFAs seem to do the job. Atherosclerosis 2024; 395:117597. [PMID: 38880705 DOI: 10.1016/j.atherosclerosis.2024.117597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 05/22/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Kristin Lehnert
- Dept. of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Stephanie Könemann
- Dept. of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Martin Bahls
- Dept. of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.
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Kemp BJ, Thompson DR, Coates V, Bond S, Ski CF, Monaghan M, McGuigan K. International guideline comparison of lifestyle management for acute coronary syndrome and type 2 diabetes mellitus: A rapid review. Health Policy 2024; 146:105116. [PMID: 38943831 DOI: 10.1016/j.healthpol.2024.105116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 05/07/2024] [Accepted: 06/16/2024] [Indexed: 07/01/2024]
Abstract
Acute coronary syndrome (ACS) is a life-threatening condition, with ACS-associated morbidity and mortality causing substantial human and economic challenges to the individual and health services. Due to shared disease determinants, those with ACS have a high risk of comorbid Type 2 diabetes mellitus (T2DM). Despite this, the two conditions are managed separately, duplicating workload for staff and increasing the number of appointments and complexity of patient management plans. This rapid review compared current ACS and T2DM guidelines across Australia, Canada, Europe, Ireland, New Zealand, the UK, and the USA. Results highlighted service overlap, repetition, and opportunities for integrated practice for ACS-T2DM lifestyle management across diet and nutrition, physical activity, weight management, clinical and psychological health. Recommendations are made for potential integration of ACS-T2DM service provision to streamline care and reduce siloed care in the context of the health services for ACS-T2DM and similar comorbid conditions.
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Affiliation(s)
- Bridie J Kemp
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Vivien Coates
- School of Nursing and Paramedic Science, Ulster University, Magee Campus, Londonderry, UK
| | - Sarah Bond
- School of Nursing and Paramedic Science, Ulster University, Magee Campus, Londonderry, UK
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK; Australian Centre for Heart Health, Deakin University, Melbourne, Australia
| | | | - Karen McGuigan
- Queen's Communities and Place, Queen's University Belfast, Belfast, UK.
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Wildenauer A, Maurer LF, Rötzer L, Eggert T, Schöbel C. The effects of a digital lifestyle intervention in patients with hypertension: Results of a pilot randomized controlled trial. J Clin Hypertens (Greenwich) 2024. [PMID: 38992970 DOI: 10.1111/jch.14811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 07/13/2024]
Abstract
In this pilot study, the authors investigated the preliminary effectiveness of the digital lifestyle intervention, actensio (mementor DE GmbH), in treating arterial hypertension. Adults with arterial hypertension were randomly assigned to an intervention group (actensio + standard care) or a control group (waiting list + standard care) in a 1:1 ratio. Primary and secondary endpoints were assessed at baseline (t0) and 3 months post-randomization (t1). The primary endpoint was average systolic blood pressure, measured at home for 1 week. Secondary endpoints included patient engagement (measured using the "patient activation measure"; PAM-13), average diastolic blood pressure, and heart rate. All endpoints were analyzed using ANCOVA models, following an intention-to-treat approach, while adjusting for baseline values. Missing data were estimated using multiple imputation models. A total of N = 102 participants (f = 59, age = 52.94 ± 9.01) were randomized to either the intervention (IG; N = 52) or the control group (CG; N = 50), of which N = 80 completed the blood pressure diary, and N = 81 the PAM-13 at t1. Between-group comparisons showed an average group difference in systolic blood pressure of -5.06 mm Hg (95% CI = -8.71 to -1.41, p = .013) between the intervention group (M = 137.37 ± 10.13) and the control group (M = 142.35 ± 11.23). Average group difference for patient engagement was 3.35 points with a trend towards statistical significance (95% CI = -018 to 6.89, p = .064), favoring the intervention group (MIG = 79.38 ± 9.44 vs. MCG = 75.45 ± 10.62). There were no group differences in diastolic blood pressure (-1.78 mm Hg; 95% CI = -4.50 to 0.95, p = .402) and heart rate (-0.684; 95% CI = -3.73 to 2.36, p = 0.683). The results of the present pilot study confirm the preliminary effectiveness of the digital lifestyle intervention, actensio, in reducing high blood pressure in patients with hypertension.
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Affiliation(s)
| | | | | | - Torsten Eggert
- Universitätsmedizin Essen, Ruhrlandklinik, Essen, Germany
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Bjerre HL, Mols RE, Bakos I, Frausing MHJP, Horváth-Puhó E, Witt CT, Eiskjær H, Løgstrup BB, Kronborg MB, Nielsen JC. Labor Market Participation Among Working-Age Heart Failure Patients With a Cardiac Resynchronization Therapy Device. J Cardiopulm Rehabil Prev 2024:01273116-990000000-00162. [PMID: 38985002 DOI: 10.1097/hcr.0000000000000884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
PURPOSE Labor market participation is an important rehabilitation goal for working-age patients living with heart failure (HF). Cardiac resynchronization therapy (CRT) reduces mortality and HF hospitalizations and improves quality of life, but no studies have investigated labor market participation following CRT. We therefore aimed to describe labor market participation in patients with HF before and after CRT implantation. METHODS This region-wide register-based cohort study comprised patients with HF aged 40 to 63 yr, with ejection fraction ≤35% and QRS duration >130 milliseconds, who received a CRT system from 2000 to 2017 in the Central Denmark Region. Using unambiguous, individual-level linkage in Danish medical and administrative registries, we assessed weekly employment status from 1 yr prior to CRT implantation until 2 to 5 yr of follow-up and conducted stratified analyses by sociodemographic and disease-related risk factors. RESULTS We identified 546 patients, of whom 42% were in early retirement 1 yr prior to implantation. Active employment decreased from 45% to 19% from 1 yr before until implantation, declining primarily in the last 8 wk before implantation. The proportion of patients in active employment increased in the first 8 wk after CRT implantation and then stabilized, reaching 31% at 1-yr follow-up. We observed lower labor market participation in patients with older age, multimorbidity, lower educational level, and upgrade procedures, but higher in later calendar year. CONCLUSIONS In working-age patients with HF, labor market participation increased after CRT implantation, despite many patients being retired prior to implantation. We observed differences in active employment related to several sociodemographic and disease-related factors.
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Affiliation(s)
- Henrik Laurits Bjerre
- Author Affiliations: Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Drs Bjerre, Mols, Frausing, Eiskjær, Løgstrup, Kronborg, and Nielsen); Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Drs Bjerre, Mols, Frausing, Witt, Eiskjær, Løgstrup, Kronborg, and Nielsen); and Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark (Mr Bakos and Ms Horváth-Puhó)
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Fejes R, Pilat N, Lutnik M, Weisshaar S, Weijler AM, Krüger K, Draxler A, Bragagna L, Peake JM, Woodman RJ, Croft KD, Bondonno CP, Hodgson JM, Wagner KH, Wolzt M, Neubauer O. Effects of increased nitrate intake from beetroot juice on blood markers of oxidative stress and inflammation in older adults with hypertension. Free Radic Biol Med 2024; 222:519-530. [PMID: 38972612 DOI: 10.1016/j.freeradbiomed.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/21/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Vascular oxidative stress and low-grade inflammation are important in the pathology of cardiovascular disorders, including hypertension. Cell culture and animal studies suggest that inorganic dietary nitrate may attenuate oxidative stress and inflammation through nitric oxide (NO), and there is a need to investigate whether this translates to humans. AIM In this randomised, placebo-controlled crossover study, by measuring a combination of multiple blood biomarkers, we evaluated whether previously reported benefits of dietary nitrate translate to a reduced oxidative stress and an improved inflammation status in 15 men and women (age range: 56-71 years) with treated hypertension. METHODS We investigated the effects of a single ∼400 mg-dose of nitrate at 3 h post-ingestion (3H POST) and the daily consumption of 2 × ∼400 mg of nitrate over 4 weeks (4WK POST), through nitrate-rich versus nitrate-depleted (placebo) beetroot juice. Measurements included plasma nitrate and nitrite (NOx), oxidised low-density lipoprotein (oxLDL), F2-isoprostanes, protein carbonyls, oxidised (GSSG) and reduced glutathione (GSH); and serum high-sensitive C-reactive protein (hsCRP), chemokines, cytokines, and adhesion molecules. Flow cytometry was used to assess the relative proportion of blood monocyte subsets. RESULTS At 4WK POST nitrate intervention, the oxLDL/NOx ratio decreased (mainly due to increases in plasma nitrate and nitrite) and the GSH/GSSG ratio (a sensitive biomarker for alterations in the redox status) increased, compared with placebo (for both ratios P < 0.01). The relative proportion of classical (CD14+CD16-) monocytes decreased at 4WK POST for placebo compared to nitrate intervention (P < 0.05). Other oxidative stress and inflammatory markers were not altered by increased nitrate intake relative to placebo. CONCLUSIONS The data from this study point toward a subtle alteration in the redox balance toward a less pro-oxidative profile by a regular intake of inorganic nitrate from plant foods. CLINICAL TRIAL REGISTRY NUMBER NCT04584372 (ClinicialTrials.gov).
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Affiliation(s)
- Rebeka Fejes
- Department of Nutritional Sciences, Research Platform Active Ageing, University of Vienna, Vienna, Austria; Research Platform Active Ageing, University of Vienna, Vienna, Austria; Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Vienna, Austria
| | - Nina Pilat
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria; Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria; Department of General Surgery, Division of Transplantation, Medical University of Vienna, Vienna, Austria
| | - Martin Lutnik
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Stefan Weisshaar
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Anna M Weijler
- Department of General Surgery, Division of Transplantation, Medical University of Vienna, Vienna, Austria
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Agnes Draxler
- Department of Nutritional Sciences, Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Laura Bragagna
- Department of Nutritional Sciences, Research Platform Active Ageing, University of Vienna, Vienna, Austria; Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Vienna, Austria
| | - Jonathan M Peake
- School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Kevin D Croft
- Medical School, University of Western Australia, Royal Perth Hospital Unit, Perth, Western Australia, Australia
| | - Catherine P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Royal Perth Hospital Research Foundation, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jonathan M Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Royal Perth Hospital Research Foundation, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Karl-Heinz Wagner
- Department of Nutritional Sciences, Research Platform Active Ageing, University of Vienna, Vienna, Austria; Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Michael Wolzt
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Oliver Neubauer
- Department of Nutritional Sciences, Research Platform Active Ageing, University of Vienna, Vienna, Austria; Research Platform Active Ageing, University of Vienna, Vienna, Austria; Centre for Health Sciences and Medicine, University for Continuing Education Krems, Krems, Austria.
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8
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Sowan W, Kissane D. Demoralization and well-being among self-employed individuals with cardiac disease: the role of intolerance of uncertainty. Front Psychol 2024; 15:1388032. [PMID: 39021650 PMCID: PMC11253239 DOI: 10.3389/fpsyg.2024.1388032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Background Individuals with cardiac disease (CD) who are self-employed may experience ability limitations and especially intensive challenges and uncertainties. These challenges may cause demoralization and impaired well-being. Objectives To examine: (a) whether work ability limitations are related to demoralization and well-being among self-employed people with CD; (b) rates of demoralization; and (c) how demoralization and intolerance of uncertainty (IU) are associated with well-being. Methods The study involved 120 self-employed individuals with CD. The PROCESS macro was used to analyze mediation and moderation processes. Results The prevalence of demoralization syndrome was 37.4%. Work ability-limitations were associated with higher demoralization levels. Demoralization was associated with well-being only among participants with high IU. Further, demoralization mediated the relationship between work ability limitations and well-being only for individuals with high IU. Conclusion Encountering limitations among self-employed was associated with demoralization and lower levels of well-being, especially among those with high IU. In addition, demoralization syndrome is prevalent among individuals with CD in general. Early recognition and treatment of demoralization as a treatable psychological syndrome are essential for preventing its degeneration into more complex forms. In addition to uncertainty related to health, it is important to pay special attention to other sources of uncertainty.
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Affiliation(s)
- Wafaa Sowan
- School of Social Work, University of Haifa, Haifa, Israel
| | - David Kissane
- Centre for Palliative Care, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
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Lamb RJ, Griffiths K, Lip GYH, Sorokin V, Frenneaux MP, Feelisch M, Madhani M. ALDH2 polymorphism and myocardial infarction: From alcohol metabolism to redox regulation. Pharmacol Ther 2024; 259:108666. [PMID: 38763322 DOI: 10.1016/j.pharmthera.2024.108666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
Acute myocardial infarction (AMI) remains a leading cause of death worldwide. Increased formation of reactive oxygen species (ROS) during the early reperfusion phase is thought to trigger lipid peroxidation and disrupt redox homeostasis, leading to myocardial injury. Whilst the mitochondrial enzyme aldehyde dehydrogenase 2 (ALDH2) is chiefly recognised for its central role in ethanol metabolism, substantial experimental evidence suggests an additional cardioprotective role for ALDH2 independent of alcohol intake, which mitigates myocardial injury by detoxifying breakdown products of lipid peroxidation including the reactive aldehydes, malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE). Epidemiological evidence suggests that an ALDH2 mutant variant with reduced activity that is highly prevalent in the East Asian population increases AMI risk. Additional studies have uncovered a strong association between coronary heart disease and this ALDH2 mutant variant. It appears this enzyme polymorphism (in particular, in ALDH2*2/2 carriers) has the potential to have wide-ranging effects on thiol reactivity, redox tone and therefore numerous redox-related signaling processes, resilience of the heart to cope with lifestyle-related and environmental stressors, and the ability of the whole body to achieve redox balance. In this review, we summarize the journey of ALDH2 from a mitochondrial reductase linked to alcohol metabolism, via pre-clinical studies aimed at stimulating ALDH2 activity to reduce myocardial injury to clinical evidence for its protective role in the heart.
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Affiliation(s)
- Reece J Lamb
- Institute of Cardiovascular Sciences, The Medical School, University of Birmingham, United Kingdom
| | - Kayleigh Griffiths
- Institute of Cardiovascular Sciences, The Medical School, University of Birmingham, United Kingdom
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Danish Centre for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Vitaly Sorokin
- Department of Cardiac, Thoracic, and Vascular Surgery, National University Heart Centre, National University Health System, Singapore
| | | | - Martin Feelisch
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton and NIHR Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom
| | - Melanie Madhani
- Institute of Cardiovascular Sciences, The Medical School, University of Birmingham, United Kingdom.
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Liu P, Wang J, Mei P, Li J, Xu B, Ren X, Chen X, Wu D, Zhu F, Yang X, He M, Liu J, Huang H. The interaction effect of metals exposure and dietary habit on cognitive function in Chinese older adult cohort. J Nutr Health Aging 2024; 28:100284. [PMID: 38833765 DOI: 10.1016/j.jnha.2024.100284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/12/2024] [Accepted: 05/26/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND As the important factors in cognitive function, dietary habits and metal exposures are interactive with each other. However, fewer studies have investigated the interaction effect of them on cognitive dysfunction in older adults. METHODS 2,445 registered citizens aged 60-85 years from 51 community health centers in Luohu District, Shenzhen, were recruited in this study based on the Chinese older adult cohort. All subjects underwent physical examination and Mini-cognitive assessment scale. A semi quantitative food frequency questionnaire was used to obtain their food intake frequency, and 21 metal concentrations in their urine were measured. RESULTS Elastic-net regression model, a machine learning technique, identified six variables that were significantly associated with cognitive dysfunction in older adults. These variables included education level, gender, urinary concentration of arsenic (As) and cadmium (Cd), and the frequency of monthly intake of egg and bean products. After adjusting for multiple factors, As and Cd concentrations were positively associated with increased risk of mild cognitive impairment (MCI) in the older people, with OR values of 1.19 (95% CI: 1.05-1.42) and 1.32 (95% CI: 1.01-1.74), respectively. In addition, older adults with high frequency of egg intake (≥30 times/month) and bean products intake (≥8 times/month) had a reduced risk of MCI than those with low protein egg intake (<30 times/month) and low bean products intake (<8 times/month), respectively. Furthermore, additive interaction were observed between the As exposure and egg products intake, as well as bean products. Cd exposure also showed additive interactions with egg and bean products intake. CONCLUSIONS The consumption of eggs and bean products, as well as the levels of exposure to the heavy metals Cd and As, have been shown to have a substantial influence on cognitive impairment in the elderly population.
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Affiliation(s)
- Peiyi Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Jiahui Wang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Pengcheng Mei
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Junyu Li
- Food Inspection and Quarantine Technology Center of Shenzhen Customs, Shenzhen, 518033, China
| | - Benhong Xu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Xiaohu Ren
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Xiao Chen
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Desheng Wu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, the Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen, 518020, China
| | - Xifei Yang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Meian He
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Jianjun Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China.
| | - Haiyan Huang
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China.
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11
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Lasek-Bal A, Konka A, Puz P, Boidol J, Kosarz-Lanczek K, Puz A, Wagner-Kusz A, Tomasik A, Student S. The Usefulness of Outpatient Cardiac Telemetry in Patients with Cryptogenic Stroke. J Clin Med 2024; 13:3819. [PMID: 38999384 PMCID: PMC11242364 DOI: 10.3390/jcm13133819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/14/2024] Open
Abstract
Introduction: Atrial fibrillation (AF), apart from non-stenotic supracardiac atherosclerosis and neoplastic disease, is the leading cause of cryptogenic stroke, including embolic stroke of un-determined source (ESUS). The aim of our study was to determine the prevalence of AF in ESUS patients based on 30-day telemetric heart rate monitoring initiated within three months after stroke onset. Another aim was to identify factors that increase the likelihood of detecting subsequent AF among ESUS patients. Material and Methods: patients with first-ever stroke classified as per the ESUS definition were eligible for this study. All patients underwent outpatient 30-day telemetric heart rate monitoring. Results: In the period between 2020 and 2022, 145 patients were included. The mean age of all qualified patients was 54; 40% of eligible patients were female. Six patients (4.14%), mostly male patients (4 vs. 2), were diagnosed with AF within the study period. In each case, the diagnosis related to a patient whose stroke occurred in the course of large vessel occlusion. Episodes of AF were detected between day 1 and 25 after starting ECG monitoring. Out of the analyzed parameters that increase the probability of, A.F.; only supraventricular extrasystoles proved to be an independent factor regarding an increased risk of AF [OR 1.046, CI 95% 1.016-1.071, p-value < 0.01]. Conclusions: The use of telemetry heart rhythm monitoring in an outpatient setting can detect AF in 4% of ESUS patients who have undergone prior diagnostic procedures for cardiogenic embolism. Supraventricular extrasystoles significantly increases the likelihood of AF detection in patients with ESUS within three months following stroke. Comorbid coronary artery disease, diabetes and hypertension, rather than a single-factor clinical burden, increase the likelihood of AF detection in older ESUS patients. ESUS in the course of large vessel occlusion is probably associated with an increased likelihood of cardiogenic embolism.
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Affiliation(s)
- Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
- Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, 40-055 Katowice, Poland; (K.K.-L.)
| | - Adam Konka
- Silesian Park of Medical Technology Kardio-Med Silesia, 42-800 Zabrze, Poland; (A.K.); (A.T.)
| | - Przemysław Puz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
- Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, 40-055 Katowice, Poland; (K.K.-L.)
| | - Joanna Boidol
- Silesian Park of Medical Technology Kardio-Med Silesia, 42-800 Zabrze, Poland; (A.K.); (A.T.)
- 1st Department of Cardiology and Angiology, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland
| | - Katarzyna Kosarz-Lanczek
- Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, 40-055 Katowice, Poland; (K.K.-L.)
| | - Agnieszka Puz
- Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, 40-055 Katowice, Poland; (K.K.-L.)
| | - Anna Wagner-Kusz
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
- Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, 40-055 Katowice, Poland; (K.K.-L.)
| | - Andrzej Tomasik
- Silesian Park of Medical Technology Kardio-Med Silesia, 42-800 Zabrze, Poland; (A.K.); (A.T.)
- 2nd Department of Cardiology in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
| | - Sebastian Student
- Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, 44-100 Gliwice, Poland;
- Biotechnology Center, Silesian University of Technology, 44-100 Gliwice, Poland
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12
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Kopp K, Motloch LJ, Wernly B, Berezin AE, Maringgele V, Dieplinger A, Hoppe UC, Lichtenauer M. Implementation of risk-based lipid-lowering therapies in older (age ≥ 65 years) and very-old adults (age ≥ 75 years) with ischemic heart disease in the greater Salzburg region. Front Pharmacol 2024; 15:1357334. [PMID: 38966548 PMCID: PMC11223559 DOI: 10.3389/fphar.2024.1357334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/17/2024] [Indexed: 07/06/2024] Open
Abstract
Introduction: European guidelines recommend the implementation of lipid-lowering therapies (LLTs) in adults (≥ 65 years) with established atherosclerotic cardiovascular disease (ASCVD) and for risk-based primary prevention in older adults (≤ 75 years), yet their use in very-old adults (> 75 years) is controversial, discretionary, and oriented on the presence of risk factors. The aim of this retrospective study is to assess guideline-directed LLT implementation and low-density lipoprotein cholesterol (LDL-C) target achievement in high-/very-high-risk older/very-old adults (65-74 and ≥ 75 years) at presentation for ST-segment elevation myocardial infarction (STEMI) and also to assess evidence-based care delivery to older adults in our region. Methods: All STEMI patients with available LDL-C and total cholesterol presenting for treatment at a large tertiary center in Salzburg, Austria, 2018-2020, were screened (n = 910). High-risk/very-high-risk patients (n = 369) were classified according to European guidelines criteria and divided into cohorts by age: < 65 years (n = 152), 65-74 years (n = 104), and ≥ 75 years (n = 113). Results: Despite being at high-/very-high-risk, prior LLT use was < 40% in the total cohort, with no significant difference by age. Statin monotherapy predominated; 20%-23% of older/very-old adults in the entire cohort were using low-/moderate-intensity stains, 11%-13% were using high-intensity statins, 4% were on ezetimibe therapy, and none were taking proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. In the secondary prevention cohort, 53% of older/very-old patients used prior LLTs. Significantly higher percentages of older/oldest ASCVD patients (43% and 49%) met LDL-C targets < 70 mg/dL compared to patients < 65 years (29%; p = 0.033), although just 22% and 30% of these older groups attained stricter LDL-C targets of < 55 mg/dL. Low LLT uptake (16%) among older adults aged 64-74 years for primary prevention resulted in 17% and 10% attainment of risk-based LDL-C targets < 70 mg/dL and < 55 mg/dL, respectively. Oldest adults (≥ 75 years) in both primary and secondary prevention groups more often met risk-based targets than older and younger adults, despite predominantly receiving low-/moderate-intensity statin monotherapy. Conclusion: Secondary prevention was sub-optimal in our region. Less than half of older/very-old adults with established ASCVD met LDL-C targets at the time of STEMI, suggesting severe care-delivery deficits in LLT implementation. Shortcomings in initiation of risk-based LLTs were also observed among high-/very-high-risk primary prevention patients < 75 years, with the achievement of risk-based LDL-C targets in 10%-48% of these patients.
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Affiliation(s)
- Kristen Kopp
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | - Lukas J. Motloch
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
- Department of Internal Medicine II, Salzkammergut Klinikum, OOEG, Voecklabruck, Austria
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Bernhard Wernly
- Institute for General-, Family- and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Alexander E. Berezin
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | - Victoria Maringgele
- Department of Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Anna Dieplinger
- Institute for Nursing and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Uta C. Hoppe
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | - Michael Lichtenauer
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
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13
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Caloian CS, Șurlin P, Ciurea A, Pop D, Caloian B, Leucuța DC, Țigu AB, Rasperini G, Micu IC, Stanomir A, Soancă A, Roman A. Exploring Periodontal Conditions, Salivary Markers, and Systemic Inflammation in Patients with Cardiovascular Diseases. Biomedicines 2024; 12:1341. [PMID: 38927548 PMCID: PMC11201987 DOI: 10.3390/biomedicines12061341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: This cross-sectional investigation appreciated the role of serum C-reactive protein (CRP), several hematologic-cell markers, and salivary inflammation-related molecules [calprotectin (S100A8/A9), interleukin-1β (IL-1β), kallikrein] to predict periodontitis in patients with atherosclerotic cardiovascular disease (ACVD), arrhythmia, or both. Also, we appreciated the relationship between the inflammatory burden and periodontal destruction with the type of cardiac pathology. (2) Methods: Demographic, behavioral characteristics, periodontal indicators, blood parameters, and saliva samples were collected. (3) Results: All 148 patients exhibited stage II or III/IV periodontitis. Stage III/IV cases exhibited significantly increased S100A8/A9 levels (p = 0.004). A positive correlation between S100A8/A9 and IL-1β [0.35 (<0.001)], kallikrein [0.55 (<0.001)], and CRP [0.28 (<0.001)] was observed. Patients with complex cardiac involvement had a significantly higher number of sites with attachment loss ≥ 5 mm [19 (3-30)] compared to individuals with only arrhythmia [9 (3.25-18)] or ACVD [5 (1-12)] [0.048♦ {0.162/0.496/0.14}]. (4) Conclusions: Severe, extensive attachment loss may be indicative of patients with complex cardiac conditions, which underscores the essential role of periodontal status in relation to systemic diseases. The correlations between the rising trends of the inflammatory parameters suggest a potential interconnection between oral and systemic inflammation.
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Affiliation(s)
- Carmen Silvia Caloian
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.); (A.R.)
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania;
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.); (A.R.)
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania;
| | - Dana Pop
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania;
- Department of Cardiology-Rehabilitation, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 4000347 Cluj-Napoca, Romania
| | - Bogdan Caloian
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania;
- Department of Cardiology-Rehabilitation, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 4000347 Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Adrian Bogdan Țigu
- Research Centre for Advanced Medicine (MEDFUTURE), Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca’ Granda Policlinic, Via della Commenda 12, 20122 Milan, Italy;
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.); (A.R.)
| | - Alina Stanomir
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.); (A.R.)
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.); (A.R.)
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania;
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.); (A.R.)
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania;
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14
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Sentandreu-Mañó T, Torres Z, Luján-Arribas C, Tomás JM, González-Cervantes JJ, Marques-Sule E. Linking Myocardial Infarction and Frailty Status at Old Age in Europe: Moderation Effects of Country and Gender. J Cardiovasc Dev Dis 2024; 11:176. [PMID: 38921676 PMCID: PMC11203841 DOI: 10.3390/jcdd11060176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Myocardial infarction (MI) is a serious condition affecting a considerable number of individuals, with important clinical consequences. Understanding the associated factors is crucial for effective management and prevention. This study aimed to (1) examine the association between MI and frailty in a sample of older European adults and (2) investigate the moderating effects of country and gender on this association. METHODS A cross-sectional survey of 22,356 Europeans aged 60 years and older was conducted. The data come from the sixth wave of the Survey of Health, Ageing and Retirement in Europe. Frailty, MI, gender, and country were studied. RESULTS Frailty is strongly associated with MI. Robust older adults are 13.31 times more likely not to have an MI. However, these odds drop to 5.09 if pre-frail and to 2.73 if frail. Gender, but not country, moderates this relationship. There is a strong association between MI and frailty in men, whereas for women, the association is not as strong. CONCLUSIONS Frailty is highly associated with MI in European older adults. Country did not moderate the link between frailty and MI but gender does, with the relationship being notably stronger in men. The frailty-MI association remained significant even when controlling for a number of personal conditions and comorbidities.
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Affiliation(s)
- Trinidad Sentandreu-Mañó
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (T.S.-M.); (C.L.-A.); (E.M.-S.)
| | - Zaira Torres
- Department of Methodology for the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain;
| | - Cecilia Luján-Arribas
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (T.S.-M.); (C.L.-A.); (E.M.-S.)
| | - José M. Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, 46010 Valencia, Spain;
| | | | - Elena Marques-Sule
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; (T.S.-M.); (C.L.-A.); (E.M.-S.)
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15
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Bibi A, Bartekova M, Gandhi S, Greco S, Madè A, Sarkar M, Stopa V, Tastsoglou S, de Gonzalo-Calvo D, Devaux Y, Emanueli C, Hatzigeorgiou AG, Nossent AY, Zhou Z, Martelli F. Circular RNA regulatory role in pathological cardiac remodelling. Br J Pharmacol 2024. [PMID: 38830749 DOI: 10.1111/bph.16434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/14/2024] [Accepted: 04/12/2024] [Indexed: 06/05/2024] Open
Abstract
Cardiac remodelling involves structural, cellular and molecular alterations in the heart after injury, resulting in progressive loss of heart function and ultimately leading to heart failure. Circular RNAs (circRNAs) are a recently rediscovered class of non-coding RNAs that play regulatory roles in the pathogenesis of cardiovascular diseases, including heart failure. Thus, a more comprehensive understanding of the role of circRNAs in the processes governing cardiac remodelling may set the ground for the development of circRNA-based diagnostic and therapeutic strategies. In this review, the current knowledge about circRNA origin, conservation, characteristics and function is summarized. Bioinformatics and wet-lab methods used in circRNA research are discussed. The regulatory function of circRNAs in cardiac remodelling mechanisms such as cell death, cardiomyocyte hypertrophy, inflammation, fibrosis and metabolism is highlighted. Finally, key challenges and opportunities in circRNA research are discussed, and orientations for future work to address the pharmacological potential of circRNAs in heart failure are proposed.
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Affiliation(s)
- Alessia Bibi
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- Department of Biosciences, University of Milan, Milan, Italy
| | - Monika Bartekova
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
- Institute of Physiology, Comenius University in Bratislava, Bratislava, Slovakia
| | - Shrey Gandhi
- Institute of Immunology, University of Münster, Münster, Germany
- Department of Genetic Epidemiology, Institute of Human Genetics, University of Münster, Münster, Germany
| | - Simona Greco
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Alisia Madè
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Moumita Sarkar
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Victoria Stopa
- Cardiovascular Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Spyros Tastsoglou
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- DIANA-Lab, Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
- Hellenic Pasteur Institute, Athens, Greece
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Yvan Devaux
- Cardiovascular Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Costanza Emanueli
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Artemis G Hatzigeorgiou
- DIANA-Lab, Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
- Hellenic Pasteur Institute, Athens, Greece
| | - A Yaël Nossent
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Zhichao Zhou
- Division of Cardiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Fabio Martelli
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
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Gupta R, Gaur K, Ahuja S, Anjana RM. Recent studies on hypertension prevalence and control in India 2023. Hypertens Res 2024; 47:1445-1456. [PMID: 38379011 DOI: 10.1038/s41440-024-01585-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 02/22/2024]
Abstract
Hypertension is the most important chronic disease risk factor in India. Recent epidemiological studies have reported that hypertension is increasing in India with a more rapid increase in rural and young populations. Fifth National Family Health Survey (NFHS-5) and Indian Council of Medical Research-INDIAB surveys have reported that there are substantial geographic variations in hypertension prevalence with greater prevalence in more developed states and districts of the country. There is a high prevalence of young-age hypertension, especially in the less developed states. The incidence of adverse events from hypertension-related cardiovascular disease is significantly greater in India than in more developed countries. A low level of hypertension awareness, treatment, and control, especially in rural and underserved urban populations is an important finding. In this narrative review, we highlight recent nationwide studies and unique features of hypertension in India and suggest strategies for better hypertension management and control.
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Affiliation(s)
- Rajeev Gupta
- Department of Preventive Cardiology & Medicine, Eternal Heart Care Centre & Research Institute, Jaipur, India.
- Research Board, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India.
| | - Kiran Gaur
- Department of Statistics, Mathematics and Computer Science, Government SKN Agriculture University, Jobner, Jaipur, India
| | - Shiva Ahuja
- Department of Orthodontics, Jaipur Dental College, Jaipur, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr Mohan's Diabetes Research Centre, Chennai, India
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17
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Ba HO, Camara Y, Poudiougou M, Sangaré I, Sidibé N, Traoré D, Menta I. Changes in patient profiles in the cardiology department of the University Hospital Gabriel Touré (UH-GT) : results of two cross-sectional studies of 2010 and 2022. BMC Cardiovasc Disord 2024; 24:290. [PMID: 38822250 PMCID: PMC11143634 DOI: 10.1186/s12872-024-03890-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/12/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Little is known about patient profile changes in medical facilities in our country, leading to this study to describe and compare patient profiles in 2010 and 2022. PATIENTS AND METHODS This was a cross-sectional study with new outpatients aged 15 years and more seen in the cardiology department of the UH-GT. Measurements included height, weight and body mass index (BMI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Quantitative data are presented as the mean with standard deviation, and categorical one as proportions. Statistical tests were the t test to compare means and chi-test for categorical variables. The level of significance was set to 0.05. RESULTS The sample consisted of 515 new patients (199 in 2010 and 316 in 2022) with 59.1% female in 2010 and 60.1% in 2022 (p = 0.821). We noticed an increase in hypertension (59.1-71.8%, p = 0.003) and a decrease in tobacco smoking (from 13 to 05.4%, p = 0.002) and stroke (from 05.8 to 02.2%, p = 0.033). Height increased significantly from 1.59 m to 1.66 m, p = 0.002. SBP and DBP showed significant decreases in their means from 155.43 to 144.97 mmHg, p = < 0.001 for SBP and from 95.53 to 89.02 mmHg, p = < 0.001 for DBP. CONCLUSIONS Cardiovascular risk factors showed different trends with decreasing tobacco smoking, similar to systolic and diastolic blood pressure, albeit with an increase in hypertension prevalence. Other CVrf values increased. Awareness campaigns must be reinforced and maintained to obtain their decrease.
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Affiliation(s)
| | - Y Camara
- University Hospital "Sidy Bocar Sall", Kati, Mali
| | - M Poudiougou
- University Hospital "Gabriel Touré", Bamako, Mali
| | - I Sangaré
- University Hospital "Gabriel Touré", Bamako, Mali
| | - N Sidibé
- University Hospital "Gabriel Touré", Bamako, Mali
| | - D Traoré
- University Hospital "Point G", Bamako, Mali
| | - I Menta
- University Hospital "Gabriel Touré", Bamako, Mali
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Vogel C, Grimm B, Marmor MT, Sivananthan S, Richter PH, Yarboro S, Hanflik AM, Histing T, Braun BJ. Wearable Sensors in Other Medical Domains with Application Potential for Orthopedic Trauma Surgery-A Narrative Review. J Clin Med 2024; 13:3134. [PMID: 38892844 PMCID: PMC11172495 DOI: 10.3390/jcm13113134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 06/21/2024] Open
Abstract
The use of wearable technology is steadily increasing. In orthopedic trauma surgery, where the musculoskeletal system is directly affected, focus has been directed towards assessing aspects of physical functioning, activity behavior, and mobility/disability. This includes sensors and algorithms to monitor real-world walking speed, daily step counts, ground reaction forces, or range of motion. Several specific reviews have focused on this domain. In other medical fields, wearable sensors and algorithms to monitor digital biometrics have been used with a focus on domain-specific health aspects such as heart rate, sleep, blood oxygen saturation, or fall risk. This review explores the most common clinical and research use cases of wearable sensors in other medical domains and, from it, derives suggestions for the meaningful transfer and application in an orthopedic trauma context.
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Affiliation(s)
- Carolina Vogel
- University Hospital Tuebingen on Behalf of the Eberhard-Karls-University Tuebingen, BG Unfallklinik, Schnarrenbergstr. 95, 72076 Tuebingen, Germany; (C.V.); (T.H.)
| | - Bernd Grimm
- Luxembourg Institute of Health, Department of Precision Health, Human Motion, Orthopaedics, Sports Medicine and Digital Methods Group, 1445 Strassen, Luxembourg;
| | - Meir T. Marmor
- Orthopaedic Trauma Institute (OTI), San Francisco General Hospital, University of California, San Francisco, CA 94158, USA;
| | | | - Peter H. Richter
- Department of Trauma and Orthopaedic Surgery, Esslingen Hospotal, 73730 Esslingen, Germany;
| | - Seth Yarboro
- Deptartment Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA;
| | - Andrew M. Hanflik
- Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Downey Medical Center, Kaiser Permanente, Downey, CA 90027, USA;
| | - Tina Histing
- University Hospital Tuebingen on Behalf of the Eberhard-Karls-University Tuebingen, BG Unfallklinik, Schnarrenbergstr. 95, 72076 Tuebingen, Germany; (C.V.); (T.H.)
| | - Benedikt J. Braun
- University Hospital Tuebingen on Behalf of the Eberhard-Karls-University Tuebingen, BG Unfallklinik, Schnarrenbergstr. 95, 72076 Tuebingen, Germany; (C.V.); (T.H.)
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Abdullayev K, Gorvett O, Sochiera A, Laidlaw L, Chico T, Manktelow M, Buckley O, Condell J, Van Arkel R, Diaz V, Matcham F. Stakeholder perspectives on contributors to delayed and inaccurate diagnosis of cardiovascular disease and their implications for digital health technologies: a UK-based qualitative study. BMJ Open 2024; 14:e080445. [PMID: 38772579 PMCID: PMC11110589 DOI: 10.1136/bmjopen-2023-080445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/05/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVE The aim of this study is to understand stakeholder experiences of diagnosis of cardiovascular disease (CVD) to support the development of technological solutions that meet current needs. Specifically, we aimed to identify challenges in the process of diagnosing CVD, to identify discrepancies between patient and clinician experiences of CVD diagnosis, and to identify the requirements of future health technology solutions intended to improve CVD diagnosis. DESIGN Semistructured focus groups and one-to-one interviews to generate qualitative data that were subjected to thematic analysis. PARTICIPANTS UK-based individuals (N=32) with lived experience of diagnosis of CVD (n=23) and clinicians with experience in diagnosing CVD (n=9). RESULTS We identified four key themes related to delayed or inaccurate diagnosis of CVD: symptom interpretation, patient characteristics, patient-clinician interactions and systemic challenges. Subthemes from each are discussed in depth. Challenges related to time and communication were greatest for both stakeholder groups; however, there were differences in other areas, for example, patient experiences highlighted difficulties with the psychological aspects of diagnosis and interpreting ambiguous symptoms, while clinicians emphasised the role of individual patient differences and the lack of rapport in contributing to delays or inaccurate diagnosis. CONCLUSIONS Our findings highlight key considerations when developing digital technologies that seek to improve the efficiency and accuracy of diagnosis of CVD.
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Affiliation(s)
| | | | - Anna Sochiera
- School of Psychology, University of Sussex, Falmer, UK
| | - Lynn Laidlaw
- Honorary Fellow, College of Health, Wellbeing and Life Sciences, Centre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK
| | - Timothy Chico
- Clinical Medicine, School of Medicine and Population Health, The Medical School, The University of Sheffield, Sheffield, UK
| | - Matthew Manktelow
- Centre for Personalised Medicine, Ulster University Faculty of Life and Health Sciences, Londonderry, UK
| | - Oliver Buckley
- School of Computing Sciences, University of East Anglia, Norwich, UK
| | - Joan Condell
- Centre for Personalised Medicine, Ulster University Faculty of Life and Health Sciences, Londonderry, UK
| | | | - Vanessa Diaz
- Department of Mechanical Engineering, University College London, London, UK
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK
| | - Faith Matcham
- School of Psychology, University of Sussex, Falmer, UK
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20
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Lei MH, Hsu YC, Chung SL, Chen CC, Chen WC, Chen WM, Jao AT, Hsiao JF, Hsu JT, Wu SY. Assessing mortality risk in Type 2 Diabetes patients with prolonged ASCVD risk factors: the inclusive Poh-Ai predictive scoring system with CAC Score integration. Diabetol Metab Syndr 2024; 16:104. [PMID: 38764060 PMCID: PMC11103845 DOI: 10.1186/s13098-024-01341-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024] Open
Abstract
PURPOSE To enhance the predictive risk model for all-cause mortality in individuals with Type 2 Diabetes (T2DM) and prolonged Atherosclerotic Cardiovascular Disease (ASCVD) risk factors. Despite the utility of the Coronary Artery Calcium (CAC) score in assessing cardiovascular risk, its capacity to predict all-cause mortality remains limited. METHODS A retrospective cohort study included 1929 asymptomatic T2DM patients with ASCVD risk factors, aged 40-80. Variables encompassed demographic attributes, clinical parameters, CAC scores, comorbidities, and medication usage. Factors predicting all-cause mortality were selected to create a predictive scoring system. By using stepwise selection in a multivariate Cox proportional hazards model, we divided the patients into three risk groups. RESULTS In our analysis of all-cause mortality in T2DM patients with extended ASCVD risk factors over 5 years, we identified significant risk factors, their adjusted hazard ratios (aHR), and scores: e.g., CAC score > 1000 (aHR: 1.57, score: 2), CAC score 401-1000 (aHR: 2.05, score: 2), and more. These factors strongly predict all-cause mortality, with varying risk groups (e.g., very low-risk: 2.0%, very high-risk: 24.0%). Significant differences in 5-year overall survival rates were observed among these groups (log-rank test < 0.001). CONCLUSION The Poh-Ai Predictive Scoring System excels in forecasting mortality and cardiovascular events in individuals with Type 2 Diabetes Mellitus and extended ASCVD risk factors.
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Affiliation(s)
- Meng-Huan Lei
- Division of Cardiology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan
| | - Yu-Chen Hsu
- Division of Cardiology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan
| | - Sheng-Liang Chung
- Division of Cardiology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan
| | - Chao-Chin Chen
- Division of Cardiology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan
| | - Wei-Cheng Chen
- Division of Cardiology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan
| | - Wan-Ming Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City, Taiwan
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City, Taiwan
| | - An-Tzu Jao
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan
| | - Ju-Feng Hsiao
- Division of Cardiology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan
| | - Jen-Te Hsu
- Division of Cardiology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan.
| | - Szu-Yuan Wu
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, No. 83, Nanchang St., Luodong Township, Yilan County, 265, Taiwan.
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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21
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Zhang Q, Shen L, Ruan H, Huang Z. cGAS-STING signaling in cardiovascular diseases. Front Immunol 2024; 15:1402817. [PMID: 38803502 PMCID: PMC11128581 DOI: 10.3389/fimmu.2024.1402817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Sterile inflammation, characterized by a persistent chronic inflammatory state, significantly contributes to the progression of various diseases such as autoimmune, metabolic, neurodegenerative, and cardiovascular disorders. Recent evidence has increasingly highlighted the intricate connection between inflammatory responses and cardiovascular diseases, underscoring the pivotal role of the Stimulator of Interferon Genes (STING). STING is crucial for the secretion of type I interferon (IFN) and proinflammatory cytokines in response to cytosolic nucleic acids, playing a vital role in the innate immune system. Specifically, research has underscored the STING pathway involvement in unregulated inflammations, where its aberrant activation leads to a surge in inflammatory events, enhanced IFN I responses, and cell death. The primary pathway triggering STING activation is the cyclic GMP-AMP synthase (cGAS) pathway. This review delves into recent findings on STING and the cGAS-STING pathways, focusing on their regulatory mechanisms and impact on cardiovascular diseases. It also discusses the latest advancements in identifying antagonists targeting cGAS and STING, and concludes by assessing the potential of cGAS or STING inhibitors as treatments for cardiovascular diseases.
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Affiliation(s)
- Qianxin Zhang
- Department of Cardiology, The People’s Hospital of Yuhuan, Taizhou, Zhejiang, China
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lijuan Shen
- Department of Cardiology, The People’s Hospital of Yuhuan, Taizhou, Zhejiang, China
| | - Hongbiao Ruan
- Department of Cardiology, The People’s Hospital of Yuhuan, Taizhou, Zhejiang, China
| | - Zhouqing Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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22
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Panagiotakos D, Sigala E, Damigou E, Loukina A, Dalmyras D, Mentzantonakis G, Barkas F, Adamidis PS, Kravvariti E, Liberopoulos E, Sfikakis PP, Tsioufis C, Pitsavos C, Chrysohoou C. The burden of cardiovascular disease and related risk factors, in Greece; the ATTICA epidemiological study (2002-2022). Hellenic J Cardiol 2024:S1109-9666(24)00113-1. [PMID: 38734306 DOI: 10.1016/j.hjc.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/04/2024] [Indexed: 05/13/2024] Open
Abstract
AIM The aim of this study was to present the burden of cardiovascular disease (CVD) and its related risk factors based on a 20-year observation period (2002-2022). METHODS In 2002, 3,042 Greek adults (aged: 45 (12) years) free of CVD, cancer, or any other chronic infections were enrolled. In 2022, the 20-year follow-up was performed on 2,169 participants (1,988 had complete data for CVD). Lifetime risk for CVDs and Disability-Adjusted-Life-Years (DALYs) lost were also calculated. RESULTS The 20-year CVD incidence was 3,600 cases/10,000 individuals (man-to-woman ratio 5:4). At the index age of 40 years, the lifetime risk for developing CVD was 68% for men and 63% for women; as the participants were getting older, the lifetime risk declined by approximately 19% and 13% for men and women, respectively, but remained at high levels, reaching 55% for both sexes. Participants between 45-55 years exhibited the highest CVD burden concerning aggregated DALYs. The burden was greater in men than in women, at ages below 35 years; beyond this age threshold, this trend shifted, and women exhibited a higher CVD burden. CONCLUSION The burden of CVD in Greece has shown increasing trends over the past 20 years as a result of the accumulative growth of the prevalence of modifiable CVD risk factors. The disability-adjusted life-years lost are the most observed ever before, urging for efficient public health strategies and measures.
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Affiliation(s)
- Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671, Athens, Greece.
| | - Evangelia Sigala
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671, Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671, Athens, Greece
| | - Asimina Loukina
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece
| | - Dimitriοs Dalmyras
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17671, Athens, Greece
| | - Georgios Mentzantonakis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, 45500 Ioannina, Greece
| | - Petros S Adamidis
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772, Athens, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772, Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece
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Ślązak A, Przybylska I, Paprocka-Borowicz M. Evaluation of Change in Body Composition, including Phase Angle, in Post-Myocardial Infarction Patients Rehabilitated under the KOS-Zawał (MC-AMI) Programme. J Clin Med 2024; 13:2784. [PMID: 38792325 PMCID: PMC11122429 DOI: 10.3390/jcm13102784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Ischaemic heart disease, including myocardial infarction, is one of the main causes leading to heart failure as a consequence of ischaemic myocardial damage. In recent years, survival in the acute phase of myocardial infarction has improved significantly, but the high mortality rate within 12 months of hospital discharge (reaching up to 9.8% in Poland) remains a challenge. Therefore, the KOS-Zawał (MC-AMI) comprehensive 12-month post-MI care programme was introduced in Poland in 2017. Aim: This study aimed to assess body composition (including, but not limited to, the phase angle, visceral fat, total body fat, redistribution between intracellular and extracellular fluid in the body, and metabolic age) using a bioelectrical impedance analysis (BIA) in post-MI patients before and after early post-MI rehabilitation who were participating in the KOS-Zawał (MC-AMI) programme. Methods: This study involved an examination (before rehabilitation) of 94 post-myocardial infarction patients who were referred to a cardiology appointment within 7-10 days of hospital discharge, during which a clinical assessment, electrocardiogram, and biochemical blood tests (complete blood count, CRP, and serum creatinine) were performed. For various reasons (death, qualification for device implantation, non-completion of rehabilitation, failure to attend a follow-up BIA), data from 55 patients who were examined twice (before and after rehabilitation) were used for the final analysis. Measurements were taken using a high-grade Tanita MC-780 BIA body composition analyser, which measured the resistance of tissues to a low-intensity electrical impulse (not perceptible to the subject). Results: Participation in rehabilitation as part of the KOS-Zawał (MC-AMI) programme was associated with a decrease in metabolic age in patients, with a reduction in visceral fat levels and levels of adipose tissue in the lower and upper limbs. Moreover, a clinically beneficial reduction in the ratio of extracellular water to total body water was also observed. These changes were statistically significant (p < 0.005). In contrast, there were no statistically significant differences in the change in phase angle values in the subjects before and after the 5-week post-infarction rehabilitation. Conclusions: Participation in early post-myocardial infarction rehabilitation as part of the KOS-Zawał (MC-AMI) programme (25 training sessions) is associated with significant improvements in body composition parameters, such as visceral adipose tissue, limb fat, and water redistribution, and, consequently, a reduction in metabolic age, despite no significant increase in phase angle values. It was hypothesised that the good baseline condition of the subjects might explain the lack of significant change in the phase angle over the short observation period. For further analysis, it would be worthwhile to increase the number of patients with baseline reduced phase angle values and monitor changes in this parameter throughout rehabilitation and the entire MC-AMI programme, because changes in the phase angle may also be influenced by other programme components such as dietary or psychological education. It is worth considering implementing a regular BIA assessment in patients in the programme as a motivating stimulus for diligent exercise and extending rehabilitation to be followed by telerehabilitation or hybrid telerehabilitation.
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Affiliation(s)
- Aleksandra Ślązak
- Department of Physiotherapy, Division of Musculoskeletal Rehabilitation, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Iga Przybylska
- Department of Physiotherapy in Internal Medicine, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland;
| | - Małgorzata Paprocka-Borowicz
- Department of Physiotherapy, Division of Musculoskeletal Rehabilitation, Wroclaw Medical University, 50-368 Wroclaw, Poland;
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24
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You S, Zhang HF, Zhang SL, Gao QY, Cai YW, Huang ZG, Wu YB, Chen YX, Wang JF, Gao JW, Liu PM. Sleep Patterns and Traditional Cardiovascular Health Metrics: Joint Impact on Major Adverse Cardiovascular Events in a Prospective Cohort Study. J Am Heart Assoc 2024; 13:e033043. [PMID: 38686862 PMCID: PMC11179879 DOI: 10.1161/jaha.123.033043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/25/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND This study examines the association between traditional cardiovascular health (CVH) metrics and major adverse cardiovascular events (MACE) incidence in individuals with diverse sleep patterns. METHODS AND RESULTS We analyzed data from 208 621 participants initially free of cardiovascular disease (CVD) in the UK Biobank study. Sleep patterns were assessed using scores for chronotype, duration, insomnia, snoring, and daytime dozing. Traditional CVH scores were derived from the Life's Simple 7 metrics. Cox proportional hazards multivariate regression assessed associations between distinct combinations of CVH and sleep scores and MACE, including nonfatal myocardial infarction, nonfatal stroke, and CVD mortality. Over a mean follow-up of 12.73 years, 9253 participants experienced incident MACE. Individuals with both a healthy sleep pattern and ideal CVH levels had the lowest MACE risk compared with those with a poor sleep pattern and poor CVH levels (hazard ratio, 0.306 [95% CI, 0.257-0.365]; P<0.001). Elevated CVH scores were associated with a reduced risk of MACE across different sleep patterns. Similar trends were observed for individual MACE components, heart failure, and all-cause mortality. These findings remained robust in sensitivity analyses and across various subgroups. CONCLUSIONS In individuals without known CVD, maintaining a favorable sleep pattern and achieving optimal CVH levels, as measured by traditional metrics, were associated with the lowest MACE risk. Enhanced CVH significantly reduced CVD risk, even in individuals with a poor sleep pattern. These results emphasize the importance of considering multiple dimensions of sleep health alongside CVH to mitigate CVD risk. REGISTRATION URL: https://www.ukbiobank.ac.uk; Unique identifier: 91090.
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Affiliation(s)
- Si You
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Hai-Feng Zhang
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Shao-Ling Zhang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Qing-Yuan Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Yang-Wei Cai
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Ze-Gui Huang
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Yu-Biao Wu
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Yang-Xin Chen
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Jing-Feng Wang
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Jing-Wei Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Pin-Ming Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
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Mastrofini A, Marino M, Karlöf E, Hedin U, Gasser TC. On the Impact of Residual Strains in the Stress Analysis of Patient-Specific Atherosclerotic Carotid Vessels: Predictions Based on the Homogenous Stress Hypothesis. Ann Biomed Eng 2024; 52:1347-1358. [PMID: 38349443 PMCID: PMC10995094 DOI: 10.1007/s10439-024-03458-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/23/2024] [Indexed: 04/06/2024]
Abstract
The identification of carotid atherosclerotic lesion at risk for plaque rupture, eventually resulting in cerebral embolism and stroke, is of paramount clinical importance. High stress in the fibrous plaque cap has been proposed as risk factor. However, among others, residual strains influence said stress predictions, but quantitative and qualitative implications of residual strains in this context are not well explored. We therefore propose a multiplicative kinematics-based Growth and Remodeling (G&R) framework to predict residual strains from homogenizing tissue stress and then investigate its implication on plaque stress. Carotid vessel morphology of four patients was reconstructed from clinical Computed Tomography-Angiography (CT-A) images and equipped with heterogeneous tissue constitutive properties assigned through a histology-based artificial intelligence image segmentation tool. As compared to a purely elastic analysis and depending on patient-specific morphology and tissue distributions, the incorporation of residual strains reduced the maximum wall stress by up to 30 % and resulted in a fundamentally different distribution of stress across the atherosclerotic wall. Regardless residual strains homogenized tissue stresses, the fibrous plaque cap may persistently be exposed to spots of high stress. In conclusion, the incorporation of residual strains in biomechanical studies of atherosclerotic carotids may be important for a reliable assessment of fibrous plaque cap stress.
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Affiliation(s)
- Alessandro Mastrofini
- Department of Civil Engineering and Computer Science Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Michele Marino
- Department of Civil Engineering and Computer Science Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Eva Karlöf
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Ulf Hedin
- Vascular Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - T Christian Gasser
- KTH Solid Mechanics, School of Engineering Sciences, KTH Royal Institute of Technology, Stockholm, Sweden.
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
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Mancia G, Brunström M, Burnier M, Grassi G, Januszewicz A, Kjeldsen SE, Muiesan ML, Thomopoulos C, Tsioufis K, Kreutz R. Rationale for the Inclusion of β-Blockers Among Major Antihypertensive Drugs in the 2023 European Society of Hypertension Guidelines. Hypertension 2024; 81:1021-1030. [PMID: 38477109 PMCID: PMC11025609 DOI: 10.1161/hypertensionaha.124.22821] [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: 03/14/2024]
Abstract
We address the reasons why, unlike other guidelines, in the 2023 guidelines of the European Society of Hypertension β-blockers (BBs) have been regarded as major drugs for the treatment of hypertension, at the same level as diuretics, calcium channel blockers, and blockers of the renin-angiotensin system. We argue that BBs, (1) reduce blood pressure (the main factor responsible for treatment-related protection) not less than other drugs, (2) reduce pooled cardiovascular outcomes and mortality in placebo-controlled trials, in which there has also been a sizeable reduction of all major cause-specific cardiovascular outcomes, (3) have been associated with a lower global cardiovascular protection in 2 but not in several other comparison trials, in which the protective effect of BBs versus the other major drugs has been similar or even greater, with a slightly smaller or no difference of global benefit in large trial meta-analyses and a similar protective effect when comparisons extend to BBs in combination versus other drug combinations. We mention the large number of cardiac and other comorbidities for which BBs are elective drugs, and we express criticism against the exclusion of BBs because of their lower protective effect against stroke in comparison trials, because, for still uncertain reasons, differences in protection against cause-specific events (stroke, heart failure, and coronary disease) have been reported for other major drugs. These partial data cannot replace global benefits as the main deciding factor for drug choice, also because in the general hypertensive population whether and which type of event might occur is unknown.
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Affiliation(s)
| | - Mattias Brunström
- Department of Public Health and Clinical Medicine, Umea University, Sweden (Mattias Brunström)
| | - Michel Burnier
- Faculty of Biology and Medicine, University of Lausanne, Switzerland (Michel Burnier)
| | - Guido Grassi
- Clinica Medica, University Milano-Bicocca, Milan, Italy (G.G.)
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland (A.J.)
| | - Sverre E. Kjeldsen
- Institute for Clinical Medicine, University of Oslo, Norway (S.E.K.)
- Departments of Cardiology and Nephrology, Ullevaal Hospital, Oslo, Norway (S.E.K.)
| | - Maria Lorenza Muiesan
- UOC 2 Medicina, ASST Spedali Civili di Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Italy (M.L.M.)
| | - Costas Thomopoulos
- Department of Cardiology, General Hospital of Athens “Laiko”, Greece (C.T.)
| | - Konstantinos Tsioufis
- First Department of Cardiology, Medical School, University of Athens, Hippokration Hospital, Greece (K.T.)
| | - Reinhold Kreutz
- Charite-Universitaetsmedizin Berlin, Institute of Clinical Pharmacology and Toxicology, Germany (R.K.)
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Wang M, Liu Z, Liu C, He W, Qin D, You M. DNAzyme-based ultrasensitive immunoassay: Recent advances and emerging trends. Biosens Bioelectron 2024; 251:116122. [PMID: 38382271 DOI: 10.1016/j.bios.2024.116122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
Immunoassay, as the most commonly used method for protein detection, is simple to operate and highly specific. Sensitivity improvement is always the thrust of immunoassays, especially for the detection of trace quantities. The emergence of artificial enzyme, i.e., DNAzyme, provides a novel approach to improve the detection sensitivity of immunoassay. Simultaneously, its advantages of simple synthesis and high stability enable low cost, broad applicability and long shelf life for immunoassay. In this review, we summarized the recent advances in DNAzyme-based immunoassay. First, we summarized the existing different DNAzymes based on their catalytic activities. Next, the common signal amplification strategies used for DNAzyme-based immunoassays were reviewed to cater to diverse detection requirements. Following, the wide applications in disease diagnosis, environmental monitoring and food safety were discussed. Finally, the current challenges and perspectives on the future development of DNAzyme-based immunoassays were also provided.
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Affiliation(s)
- Meng Wang
- Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing, 400065, PR China; Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Zhe Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, PR China; Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China; Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, PR China
| | - Chang Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, PR China; Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Wanghong He
- Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China; Laboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, 100050, PR China
| | - Dui Qin
- Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing, 400065, PR China.
| | - Minli You
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, PR China; Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China.
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Shariff S, Kwan Su Huey A, Parag Soni N, Yahia A, Hammoud D, Nazir A, Uwishema O, Wojtara M. Unlocking the gut-heart axis: exploring the role of gut microbiota in cardiovascular health and disease. Ann Med Surg (Lond) 2024; 86:2752-2758. [PMID: 38694298 PMCID: PMC11060260 DOI: 10.1097/ms9.0000000000001744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/24/2023] [Indexed: 05/04/2024] Open
Abstract
Introduction Gut microbiota has emerged as a pivotal player in cardiovascular health and disease, extending its influence beyond the gut through intricate metabolic processes and interactions with the immune system. Accumulating evidence supports a significant association between gut microbiota and cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Dietary patterns have been identified as key factors shaping the composition of the gut microbiota and exerting notable impacts on cardiovascular health. Probiotics and prebiotics have shown promise in mitigating the risks of cardiovascular disease by modulating key cardiovascular parameters. Faecal microbiota transplantation (FMT) has recently emerged as a novel and intriguing therapeutic strategy. Aim This review paper aims to explore and elucidate the multifaceted role of gut microbiota in cardiovascular health. It will also address the prevailing challenges and limitations in gut microbiota studies, emphasizing the importance of future research in overcoming these obstacles to expand our understanding of the gut-heart axis. Materials and methods A comprehensive literature search was conducted using various databases including ClinicalTrials, Google Scholar, PubMed, ScienceDirect, MEDLINE, and Ovid Resources. The search strategy included utilizing keywords such as "Gut microbiota," "Randomized controlled trials (RCTs)," "Gut-heart axis," "Dysbiosis," "Diet," "Probiotics," "Prebiotics," "Faecal Microbiota transplantation," "cardiovascular disease," "Meta-analyses," and other compatible terms thereof. Only articles written in English were considered, and selection criteria included relevance to the research objectives, reasonable sample sizes, and robust methodology. In addition to the identified articles, meta-analyses, animal models and studies, and references from the selected articles were also examined to ensure a comprehensive review of the literature. Results Dietary patterns exert a significant influence on the composition of the gut microbiota, and certain diets, such as the Mediterranean diet, have been associated with a favourable gut microbiota profile and a reduced risk of cardiovascular disease (CVD). Probiotics and prebiotics have emerged as potential interventions to mitigate CVD risks by modulating blood pressure, glycemic control, lipid profiles, and gut dysbiosis. Another innovative therapeutic approach is FMT, which involves transferring faecal material from a healthy donor to restore a balanced gut microbiota. FMT holds promise for improving cardiometabolic parameters in individuals with CVD, although further research is needed to elucidate its precise mechanisms and assess its effectiveness. Conclusion The gut microbiota is emerging as a potential therapeutic target for CVD prevention and management. However, current research has limitations, including the need for larger and more diverse studies, the challenges of establishing causality, and concerns regarding the long-term consequences and safety of gut microbiota modulation. Despite these limitations, understanding the gut-heart axis holds promise for the development of personalized therapies and interventions for cardiovascular health. Further research is needed to expand our knowledge and address the ethical and safety issues associated with gut microbiota modification.
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Affiliation(s)
- Sanobar Shariff
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Yerevan State Medical University, Yerevan, Armenia
| | - Alicia Kwan Su Huey
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Medical School, University of Glasgow, Glasgow, UK
| | - Nishant Parag Soni
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- GMERS Medical College, Ahmedabad, India
| | - Amer Yahia
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Mohamed 6 of Health Sciences, Casablanca, Morocco
| | - Doha Hammoud
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- National University of Pharmacy, Kharkiv, Ukraine
| | - Abubakar Nazir
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Olivier Uwishema
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Clinton Global Initiative University, New York, NY
- Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Magda Wojtara
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- University of Michigan Medical School; Ann Arbor, MI
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Thierstein L, Pereira-Macedo J, Duarte-Gamas L, Reis P, Myrcha P, Andrade JP, Rocha-Neves J. Polyvascular Disease Influences Long-Term Cardiovascular Morbidity in Carotid Endarterectomy. Ann Vasc Surg 2024; 102:236-243. [PMID: 37944897 DOI: 10.1016/j.avsg.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION/OBJECTIVE Carotid stenosis (CS) is an important cause of ischemic stroke. Secondary prevention lies in performing a carotid endarterectomy (CEA) procedure, the recommended treatment in most cases. When 2 or more vascular regions are simultaneously affected by atherosclerosis, mainly the carotid arteries, coronary arteries, or limb arteries, a multivessel disease polyvascular disease (PVD) is present. This study aims to assess the potential role of PVD as a long-term predictor of major adverse cardiovascular events (MACE) and all-cause mortality in patients submitted to CEA. METHODS From January 2012 to December 2021, patients submitted to CEA for carotid stenosis in a tertiary care and referral center were eligible from a prospective database. A posthoc survival analysis was performed using the Kaplan-Meier survival curve method. The primary outcome was the incidence of long-term MACE and all-cause mortality. Secondary outcomes included acute myocardial infarction (AMI), major adverse limb events (MALE), stroke, and acute heart failure (AHF). RESULTS A total of 207 patients were enrolled, with a median follow-up of 63 months. The mean age was 70.4 ± 8.9, and 163 (78.7%) were male. There were 65 (31.4%) patients that had 2 arterial vascular territories affected, and 29 (14.0%) patients had PVD in 3 arterial beds. On multivariable analysis, both MACE and all-cause mortality had as independent risk factors age (aHR 1.039, P = 0.003; aHR 1.041, P = 0.019), chronic kidney disease (aHR 2.524, P = 0.003; aHR 3.377, P < 0.001) and PVD2 (aHR 3.381, P < 0.001; aHR 2.665, P = 0.013). PVD1 was only associated with MACE as a statistically significant risk factor (aHR 2.531, 1.439-4.450, P < 0.001). CONCLUSIONS PVD in patients with cerebrovascular disease (CVD) was revealed to carry a 2-fold increased risk for all-cause mortality and MACE during long-term follow-up. PVD may be a simple yet valuable tool in predicting all-cause mortality, MACE, AMI, and MALE after CEA.
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Affiliation(s)
| | - Juliana Pereira-Macedo
- Department of surgery, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal; Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Luís Duarte-Gamas
- Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Pedro Reis
- Burn Unit-Department of Plastic Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Piotr Myrcha
- Faculty of Medicine, 1st Chair and Department of General and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland; Department of General, Vascular and Oncological Surgery, Masovian Brodnowski Hospital, Warsaw, Poland
| | - José P Andrade
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal; Faculty of Medicine, CINTESIS@RISE, Department of Biomedicine - Unit of Anatomy, University of Porto, Portugal; Faculty of Medicine, Department of Biomedicine - Unit of Anatomy, University of Porto, Portugal
| | - João Rocha-Neves
- Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Faculty of Medicine, Department of Biomedicine - Unit of Anatomy, University of Porto, Portugal.
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30
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Barkas F, Rizos CV, Liamis G, Skoumas I, Garoufi A, Rallidis L, Kolovou G, Tziomalos K, Skalidis E, Sfikas G, Kotsis V, Doumas M, Anagnostis P, Lambadiari V, Anastasiou G, Koutagiar I, Attilakos A, Kiouri E, Kolovou V, Polychronopoulos G, Koutsogianni AD, Zacharis E, Koumaras C, Antza C, Boutari C, Liberopoulos E. Obesity and atherosclerotic cardiovascular disease in adults with heterozygous familial hypercholesterolemia: An analysis from HELLAS-FH registry. J Clin Lipidol 2024; 18:e394-e402. [PMID: 38331687 DOI: 10.1016/j.jacl.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 12/26/2023] [Accepted: 01/20/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) and obesity are well-established risk factors of atherosclerotic cardiovascular disease (ASCVD). Despite high prevalence, their joint association with ASCVD remains largely unknown. OBJECTIVE To investigate the association of obesity with prevalent ASCVD in individuals with heterozygous FH (HeFH) enrolled in the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH). METHODS FH diagnosis was based on Dutch Lipid Clinic Network (DLCN) criteria. Adults with at least possible FH diagnosis (DLCN score ≥3) and available body mass index (BMI) values were included. Homozygous FH individuals were excluded. RESULTS 1655 HeFH adults (mean age 51.0 ± 14.4 years, 48.6% female) were included; 378 (22.8%) and 430 (26.0%) were diagnosed with probable and definite FH, respectively. Furthermore, 371 participants (22.4%) had obesity and 761 (46.0%) were overweight. Prevalence of ASCVD risk factors increased progressively with BMI. Prevalence of coronary artery disease (CAD) was 23.4% (3.2% for stroke and 2.7% for peripheral artery disease [PAD]), and increased progressively across BMI groups. After adjusting for traditional ASCVD risk factors and lipid-lowering medication, individuals with obesity had higher odds of established CAD (OR: 1.54, 95% CI: 1.04-2.27, p = 0.036) as well as premature CAD (OR: 1.74, 95% CI: 1.17-2.60, p = 0.009) compared with those with normal BMI. No association was found with stroke or PAD. CONCLUSIONS Over half of adults with HeFH have overweight or obesity. Obesity was independently associated with increased prevalence of CAD in this population.
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Affiliation(s)
- Fotios Barkas
- Department of Hygiene & Epidemiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece (Dr Barkas); Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - Christos V Rizos
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - George Liamis
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - Ioannis Skoumas
- Cardiology Clinic, Hippokration General Hospital, Athens, Greece (Drs Skoumas and Koutagiar)
| | - Anastasia Garoufi
- 2nd Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece (Dr Garoufi)
| | - Loukianos Rallidis
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece (Drs Rallidis and Kiouri)
| | - Genovefa Kolovou
- Cardiometabolic Centre, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens, Greece (Dr Kolovou)
| | - Konstantinos Tziomalos
- 1st Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece (Drs Tziomalos and Polychronopoulos)
| | - Emmanouil Skalidis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece (Drs Skalidis and Zacharis)
| | - George Sfikas
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki, Greece (Drs Sfikas and Koumaras)
| | - Vasilios Kotsis
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, Thessaloniki, Greece (Drs Kotsis and Antza)
| | - Michalis Doumas
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece (Drs Doumas and Boutari)
| | - Panagiotis Anagnostis
- Department of Endocrinology, Police Medical Centre, Thessaloniki, Greece (Dr Anagnostis)
| | - Vaia Lambadiari
- 2nd Propaedeutic Internal Medicine Department and Diabetes Research Unit, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece (Dr Lambadiari)
| | - Georgia Anastasiou
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - Iosif Koutagiar
- Cardiology Clinic, Hippokration General Hospital, Athens, Greece (Drs Skoumas and Koutagiar)
| | - Achilleas Attilakos
- Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, C' Pediatrics Clinic, Attikon University General Hospital, Athens, Greece (Dr Attilakos)
| | - Estela Kiouri
- Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece (Drs Rallidis and Kiouri)
| | - Vana Kolovou
- Cardiometabolic Centre, Lipid Clinic, LA apheresis Unit, Metropolitan Hospital, Athens, Greece (Dr Kolovou)
| | - Georgios Polychronopoulos
- 1st Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece (Drs Tziomalos and Polychronopoulos)
| | - Amalia-Despoina Koutsogianni
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece (Drs Rizos, Liamis, Anastasiou, Zacharis)
| | - Evangelos Zacharis
- Cardiology Clinic, University General Hospital of Heraklion, Heraklion, Greece (Drs Skalidis and Zacharis)
| | - Charalambos Koumaras
- Department of Internal Medicine, 424 General Military Training Hospital, Thessaloniki, Greece (Drs Sfikas and Koumaras)
| | - Christina Antza
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital Thessaloniki, Thessaloniki, Greece (Drs Kotsis and Antza)
| | - Chrysoula Boutari
- Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece (Drs Doumas and Boutari)
| | - Evangelos Liberopoulos
- 1st Propedeutic Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital of Athens, Athens, Greece (Dr Liberopoulos).
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Juan-Salvadores P, Castro-Rodríguez M, Jiménez-Díaz VA, Veiga C, Busto L, Fernández-Barbeira S, Iñiguez-Romo A. Sex differences in delay times in ST-segment elevation myocardial infarction: A cohort study. Med Clin (Barc) 2024:S0025-7753(24)00189-1. [PMID: 38688735 DOI: 10.1016/j.medcli.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The present study analyzes a cohort of consecutive patients with ST-segment elevation acute myocardial infarction (STEMI), evaluating the ischemia-reperfusion times from the perspective of gender differences (females versus males), with a long-term follow-up. METHODS Single-center analytical cohort study of patients with STEMI in a tertiary hospital, between January 2015 and December 2020. RESULTS A total of 2668 patients were included, 2002 (75%) men and 666 (25%) women. The time elapsed from the onset of symptoms to the opening of the artery was 197min (IQR 140-300) vs 220min (IQR 152-340), p=0.004 in men and women respectively. A delay in health care significantly impacts the occurrence of cardiovascular adverse events at follow-up, HR 1.34 [95%CI 1.06-1.70]; p=0.015. CONCLUSIONS Women took longer to go to health care services and had a longer delay both in the diagnosis of STEMI and in coronary reperfusion. It is imperative to emphasize the necessity of educating women about the recognition of ischemic heart disease symptoms, empowering them to raise early alarms and seek timely medical attention.
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Affiliation(s)
- Pablo Juan-Salvadores
- Cardiovascular Research Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain; Cardiovascular Research Group, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain.
| | - María Castro-Rodríguez
- Cardiovascular Research Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain
| | - Víctor Alfonso Jiménez-Díaz
- Cardiovascular Research Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain; Cardiovascular Research Group, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain; Interventional Cardiology Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain
| | - Cesar Veiga
- Cardiovascular Research Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain; Cardiovascular Research Group, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - Laura Busto
- Cardiovascular Research Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain; Cardiovascular Research Group, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - Saleta Fernández-Barbeira
- Cardiovascular Research Group, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain; Interventional Cardiology Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain
| | - Andrés Iñiguez-Romo
- Cardiovascular Research Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain; Cardiovascular Research Group, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain; Interventional Cardiology Unit, Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain; Department of Cardiology, Hospital Álvaro Cunqueiro, Área Sanitaria de Vigo, Spain
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Zhang Y, Zeng M, Zhang X, Yu Q, Wang L, Zeng W, Wang Y, Suo Y, Jiang X. Tiaogan daozhuo formula attenuates atherosclerosis via activating AMPK -PPARγ-LXRα pathway. JOURNAL OF ETHNOPHARMACOLOGY 2024; 324:117814. [PMID: 38286155 DOI: 10.1016/j.jep.2024.117814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 01/31/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Tiaogan Daozhuo Formula (TGDZF) is a common formulation against atherosclerosis, however, there is limited understanding of its therapeutic mechanism. AIM OF THIS STUDY To examine the effectiveness of TGDZF in the treatment of atherosclerosis and to explore its mechanisms. MATERIALS AND METHODS In ApoE-/- mice, atherosclerosis was induced by a high-fat diet for 12 weeks and treated with TGDZF at different doses. The efficacy of TGDZF in alleviating atherosclerosis was evaluated by small animal ultrasound and histological methods. Lipid levels were measured by biochemical methods. The capacity of cholesterol efflux was tested with a cholesterol efflux assay in peritoneal macrophage, and the expression of AMPKα1, PPARγ, LXRα, and ABCA1 was examined at mRNA and protein levels. Meanwhile, RAW264.7-derived macrophages were induced into foam cells by ox-LDL, and different doses of TGDZF-conducting serum were administered. Similarly, we examined differences in intracellular lipid accumulation, cholesterol efflux rate, and AMPKα1, PPARγ, LXRα, and ABCA1 levels following drug intervention. Finally, changes in the downstream molecules were evaluated following the inhibition of AMPK by compound C or PPARγ silencing by small interfering RNA. RESULTS TGDZF administration reduced aortic plaque area and lipid accumulation in aortic plaque and hepatocytes, and improved the serum lipid profiles of ApoE-/- mice. Further study revealed that its efficacy was accompanied by an increase in cholesterol efflux rate and the expression of PPARγ, LXRα, and ABCA1 mRNA and protein, as well as the promotion of AMPKα1 phosphorylation. Moreover, similar results were caused by the intervention of TGDZF-containing serum in vitro experiments. Inhibition of AMPK and PPARγ partially blocked the regulatory effect of TGDZF, respectively. CONCLUSIONS TGDZF alleviated atherosclerosis and promoted cholesterol efflux from macrophages by activating the AMPK-PPARγ-LXRα-ABCA1 pathway.
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Affiliation(s)
- Yue Zhang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Miao Zeng
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Xiaolu Zhang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Qun Yu
- School of Preclinical Medicine, Zunyi Medical University, Guizhou, China.
| | - Luming Wang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | - Wenyun Zeng
- Traditional Chinese Medicine Department, Ganzhou People's Hospital, Ganzhou, China.
| | - Yijing Wang
- School of Nursing, Tianjin University of Chinese Medicine, Tianjin, China.
| | - Yanrong Suo
- Traditional Chinese Medicine Department, Ganzhou People's Hospital, Ganzhou, China.
| | - Xijuan Jiang
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Fejes R, Lutnik M, Weisshaar S, Pilat N, Wagner KH, Stüger HP, Peake JM, Woodman RJ, Croft KD, Bondonno CP, Hodgson JM, Wolzt M, Neubauer O. Increased nitrate intake from beetroot juice over 4 weeks affects nitrate metabolism, but not vascular function or blood pressure in older adults with hypertension. Food Funct 2024; 15:4065-4078. [PMID: 38546454 PMCID: PMC11034575 DOI: 10.1039/d3fo03749e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/24/2024] [Indexed: 04/23/2024]
Abstract
The decline in vascular function and increase in blood pressure with aging contribute to an increased cardiovascular disease risk. In this randomized placebo-controlled crossover study, we evaluated whether previously reported cardiovascular benefits of plant-derived inorganic nitrate via nitric oxide (NO) translate into improved vascular function and blood pressure-lowering in 15 men and women (age range: 56-71 years) with treated hypertension. We investigated the effects of a single ∼400 mg-dose at 3 hours post-ingestion (3H POST) and the daily consumption of 2 × ∼400 mg of nitrate through nitrate-rich compared with nitrate-depleted (placebo) beetroot juice over 4 weeks (4WK POST). Measurements included nitrate and nitrite in plasma and saliva; endothelial-dependent and -independent forearm blood flow (FBF) responses to acetylcholine (FBFACh) and glyceryltrinitrate (FBFGTN); and clinic-, home- and 24-hour ambulatory blood pressure. Compared to placebo, plasma and salivary nitrate and nitrite increased at 3H and 4WK POST following nitrate treatment (P < 0.01), suggesting a functioning nitrate-nitrite-NO pathway in the participants of this study. There were no differences between treatments in FBFACh and FBFGTN-area under the curve (AUC) ratios [AUC ratios after (3H POST, 4WK POST) compared with before (PRE) the intervention], or 24-hour ambulatory blood pressure or home blood pressure measures (P > 0.05). These findings do not support the hypothesis that an increased intake of dietary nitrate exerts sustained beneficial effects on FBF or blood pressure in hypertensive older adults, providing important information on the efficacy of nitrate-based interventions for healthy vascular aging. This study was registered under ClinicialTrials.gov (NCT04584372).
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Affiliation(s)
- Rebeka Fejes
- Department of Nutritional Sciences, Research Platform Active Ageing, University of Vienna, Vienna, Austria.
- Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Vienna, Austria
| | - Martin Lutnik
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Stefan Weisshaar
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Nina Pilat
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Karl-Heinz Wagner
- Department of Nutritional Sciences, Research Platform Active Ageing, University of Vienna, Vienna, Austria.
| | - Hans-Peter Stüger
- Division Integrative Risk Assessment, Data and Statistics, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Jonathan M Peake
- School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Kevin D Croft
- Medical School, University of Western Australia, Royal Perth Hospital Unit, Perth, Western Australia, Australia
| | - Catherine P Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Royal Perth Hospital Research Foundation, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Jonathan M Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Royal Perth Hospital Research Foundation, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Michael Wolzt
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Oliver Neubauer
- Department of Nutritional Sciences, Research Platform Active Ageing, University of Vienna, Vienna, Austria.
- Centre for Health Sciences and Medicine, University for Continuing Education Krems, Krems, Austria
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Menaker Y, van den Munckhof I, Scarpa A, Placek K, Brandes-Leibovitz R, Glantzspiegel Y, Joosten LAB, Rutten JHW, Netea MG, Gat-Viks I, Riksen NP. Stratification of Atherosclerosis based on Plasma Metabolic States. J Clin Endocrinol Metab 2024; 109:1250-1262. [PMID: 38044551 DOI: 10.1210/clinem/dgad672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Indexed: 12/05/2023]
Abstract
CONTEXT Atherosclerosis is a dominant cause of cardiovascular disease (CVD), including myocardial infarction and stroke. OBJECTIVE To investigate metabolic states that are associated with the development of atherosclerosis. METHODS Cross-sectional cohort study at a university hospital in the Netherlands. A total of 302 adult subjects with a body mass index (BMI) ≥ 27 kg/m2 were included. We integrated plasma metabolomics with clinical metadata to quantify the "atherogenic state" of each individual, providing a continuous spectrum of atherogenic states that ranges between nonatherogenic states to highly atherogenic states. RESULTS Analysis of groups of individuals with different clinical conditions-such as metabolically healthy individuals with obesity, and individuals with metabolic syndrome-confirmed the generalizability of this spectrum; revealed a wide variation of atherogenic states within each condition; and allowed identification of metabolites that are associated with the atherogenic state regardless of the particular condition, such as gamma-glutamyl-glutamic acid and homovanillic acid sulfate. The analysis further highlighted metabolic pathways such as catabolism of phenylalanine and tyrosine and biosynthesis of estrogens and phenylpropanoids. Using validation cohorts, we confirmed variation in atherogenic states in healthy subjects (before atherosclerosis plaques become visible), and showed that metabolites associated with the atherogenic state were also associated with future CVD. CONCLUSION Our results provide a global view of atherosclerosis risk states using plasma metabolomics.
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Affiliation(s)
- Yuval Menaker
- The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Inge van den Munckhof
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Alice Scarpa
- Department of Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, 53115 Bonn, Germany
| | - Katarzyna Placek
- Department of Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, 53115 Bonn, Germany
| | - Rachel Brandes-Leibovitz
- The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Yossef Glantzspiegel
- The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
| | - Joost H W Rutten
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Department of Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, 53115 Bonn, Germany
| | - Irit Gat-Viks
- The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Niels P Riksen
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
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Caloian CS, Ciurea A, Negucioiu M, Roman A, Micu IC, Picoș A, Soancă A. Systemic Impact of Subgingival Infection Control in Periodontitis Patients with Cardiovascular Disease: A Narrative Review. Antibiotics (Basel) 2024; 13:359. [PMID: 38667035 PMCID: PMC11047730 DOI: 10.3390/antibiotics13040359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
INTRODUCTION Periodontitis, an infectious inflammatory condition, is a key contributor to sustained systemic inflammation, intricately linked to atherosclerotic cardiovascular disease (CVD), the leading cause of death in developed nations. Treating periodontitis with subgingival mechanical instrumentation with or without adjunctive antimicrobials reduces the microbial burden and local inflammation, while also potentially bringing systemic benefits for patients with both periodontitis and CVD. This review examines systemic effects of subgingival instrumentation with or without antimicrobial products in individuals with periodontitis and CVD, and explores intricate pathogenetic interactions between periodontitis and CVD. MATERIAL AND METHODS English-language databases (PubMed MEDLINE and Cochrane Library) were searched for studies assessing the effects of nonsurgical periodontal therapies in periodontitis patients with or without CVD. RESULTS While the ability of periodontal therapy to reduce mortality- and morbidity-related outcomes in CVD patients with periodontitis remains uncertain, some studies indicate a decrease in inflammatory markers and blood cell counts. Subgingival mechanical instrumentation delivered over multiple short sessions carries lower risks of adverse effects, particularly systemic inflammation, compared to the full-mouth delivery, making it a preferable option for CVD patients. CONCLUSIONS Subgingival mechanical instrumentation, ideally conducted in a quadrant-based therapeutic approach, to decontaminate periodontal pockets has the potential to reduce both local and systemic inflammation with minimal adverse effects in patients suffering from periodontitis and concurrent CVD.
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Affiliation(s)
- Carmen Silvia Caloian
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
| | - Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania;
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
| | - Andrei Picoș
- Department of Prevention in Dental Medicine, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu St., No. 31, 400083 Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
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Guo J, Zhong L, Ding S, Xiao G, Huang M, Zhang L, Chen Q. Number of Pregnancies and Risk of Atherosclerotic Cardiovascular Disease in Postmenopausal Women: A Cross-Sectional Study of NHANES from 1999 to 2018. J Womens Health (Larchmt) 2024. [PMID: 38607374 DOI: 10.1089/jwh.2023.0859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Background: Atherosclerotic cardiovascular disease (ASCVD) remains the most common cause of death in women. Pregnancy is an exposure unique to women leading to significant changes in maternal cardiovascular function. However, studies of the relationship between the number of pregnancies and ASCVD are rare. We aimed to clarify the association between the number of pregnancies and ASCVD. Methods: In this cross-sectional study, we used publicly available data from the National Health and Nutrition Examination Survey from 1999 to 2018. The number of pregnancies was divided into 0 (reference), 1, 2-3, 4-5, or ≥6, to create more stable estimates. A multiple logistic regression approach was used to examine the correlation between pregnancy and ASCVD in women aged 45 years or older who reported no menstruation in the past 12 months due to menopause, as well as in those aged 55 years or older, encompassing various age groups. We also separately estimated the association between the exposure of pregnancy and individual components of ASCVD. Results: In this study, age-adjusted data showed that women with six or more pregnancies had a doubled risk (odds ratio [OR]: 2.07) of ASCVD. The risk remained elevated at 1.69 times in women with four to five pregnancies and further increased to 1.90 times in women with six or more pregnancies, after adjusting for social factors. Similar patterns were observed when considering reproductive health and cardiovascular risk factors. Across the full population, every model that accounted for these variables consistently indicated that with an increasing number of pregnancies, we observed higher ORs for ASCVD risk (all p values <0.05). Conclusions: A higher number of pregnancies was associated with a higher risk of ASCVD after menopause, especially among women aged 45-64 years. Moreover, this association is particularly significant in the risk of stroke, cardiovascular heart disease, and heart attack.
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Affiliation(s)
- Jie Guo
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Lingli Zhong
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Shan Ding
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
| | - Guitao Xiao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Minhong Huang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Li Zhang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Qionghua Chen
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, China
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Mifsud JL, Galea J. Cardiovascular Risk Factors Among First-Degree Relatives of Patients with Premature Cardiovascular Disease in Malta. Baseline Findings from the CRISO Project. Vasc Health Risk Manag 2024; 20:167-176. [PMID: 38616927 PMCID: PMC11015845 DOI: 10.2147/vhrm.s449672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/29/2024] [Indexed: 04/16/2024] Open
Abstract
Purpose A family history of premature atherosclerotic cardiovascular disease (ASCVD) confers a greater risk of developing ASCVD. However, the prevalence of ASCVD risk factors among asymptomatic Maltese adults with parental or fraternal history of premature ASCVD is unknown. The study aimed to evaluate and compare their risk with the general population. Patients and Methods Posters to market the project were distributed in cardiac rehabilitation areas. Patients with premature cardiovascular disease facilitated recruitment by informing their relatives about the project. Medical doctors and cardiac rehabilitation nurses referred first-degree relatives. Posters were put up in community pharmacies, and an explanatory video clip was shared on social media for interested individuals to contact researchers. Those eligible were enrolled in a preventive cardiology lifestyle intervention. Their data were compared with the risk in the general population. Results Many first-degree relatives had a suboptimal risk profile, with 60% (N = 89) having a total cholesterol level of >5.0 mmol/L; 54% having a low-density lipoprotein-cholesterol level of >3 mmol/L; 70.5% being overweight/obese, with 62% having a waist circumference greater than the recommended values; 34.8% having hypertension; 56.2% being inadequately adherent to the Mediterranean diet; 62% being underactive, with 18% being sedentary; and 25.8% being smokers. First-degree relatives had significantly higher proportions of underactive lifestyle (p = 0.00016), high body mass index (>25kg/m2) (p = 0.006), and systolic blood pressure (p = 0.001) than the general population, with 30% having metabolic syndrome. Conclusion This study determined the prevalence of lifestyle, biochemical, physiological, and anthropometric cardiovascular risk factors among asymptomatic first-degree relatives of Maltese patients with premature ASCVD. First-degree relatives had considerable prevalences of an underactive lifestyle, hypertension, and obesity, suggesting better screening and early risk factor intervention are needed to modify their risk of ASCVD.
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Affiliation(s)
- Justin Lee Mifsud
- Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, Malta
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Joseph Galea
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Ren Z, Zhao W, Li D, Yu P, Mao L, Zhao Q, Yao L, Zhang X, Liu Y, Zhou B, Wang L. INO80-Dependent Remodeling of Transcriptional Regulatory Network Underlies the Progression of Heart Failure. Circulation 2024; 149:1121-1138. [PMID: 38152931 DOI: 10.1161/circulationaha.123.065440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Progressive remodeling of cardiac gene expression underlies decline in cardiac function, eventually leading to heart failure. However, the major determinants of transcriptional network switching from normal to failed hearts remain to be determined. METHODS In this study, we integrated human samples, genetic mouse models, and genomic approaches, including bulk RNA sequencing, single-cell RNA sequencing, chromatin immunoprecipitation followed by high-throughput sequencing, and assay for transposase-accessible chromatin with high-throughput sequencing, to identify the role of chromatin remodeling complex INO80 in heart homeostasis and dysfunction. RESULTS The INO80 chromatin remodeling complex was abundantly expressed in mature cardiomyocytes, and its expression further increased in mouse and human heart failure. Cardiomyocyte-specific overexpression of Ino80, its core catalytic subunit, induced heart failure within 4 days. Combining RNA sequencing, chromatin immunoprecipitation followed by high-throughput sequencing, and assay for transposase-accessible chromatin with high-throughput sequencing, we revealed INO80 overexpression-dependent reshaping of the nucleosomal landscape that remodeled a core set of transcription factors, most notably the MEF2 (Myocyte Enhancer Factor 2) family, whose target genes were closely associated with cardiac function. Conditional cardiomyocyte-specific deletion of Ino80 in an established mouse model of heart failure demonstrated remarkable preservation of cardiac function. CONCLUSIONS In summary, our findings shed light on the INO80-dependent remodeling of the chromatin landscape and transcriptional networks as a major mechanism underlying cardiac dysfunction in heart failure, and suggest INO80 as a potential preventative or interventional target.
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Affiliation(s)
- Zongna Ren
- Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China (Z.R., W.Z., B.Z., L.W.)
| | - Wanqing Zhao
- Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China (Z.R., W.Z., B.Z., L.W.)
| | - Dandan Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
| | - Peng Yu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
| | - Lin Mao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
| | - Quanyi Zhao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
| | - Luyan Yao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
| | - Xuelin Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
| | - Yandan Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
| | - Bingying Zhou
- Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China (Z.R., W.Z., B.Z., L.W.)
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
| | - Li Wang
- Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China (Z.R., W.Z., B.Z., L.W.)
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (D.L., P.Y., L.M., Q.Z., L.Y., X.Z., Y.L., B.Z., L.W.)
- Key Laboratory of Application of Pluripotent Stem Cells in Heart Regeneration, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (L.W.)
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Gaisenok O. Associations of Increased Red Cell Distribution Width Levels with the Severity of Carotid Artery Stenosis: Cross-sectional Study Results. J Med Ultrasound 2024; 32:148-153. [PMID: 38882626 PMCID: PMC11175381 DOI: 10.4103/jmu.jmu_46_23] [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: 04/23/2023] [Revised: 05/31/2023] [Accepted: 06/29/2023] [Indexed: 06/18/2024] Open
Abstract
Background Red blood cell distribution width (RDW) is being actively studied as a biomarker in various cardiovascular diseases (CVDs). The aim of this study was to conduct a comparative analysis of RDW in patients with carotid atherosclerosis, comparing it with an assessment of the severity of carotid artery stenosis (CAS). Methods The Duplex registry database was used to conduct this retrospective cross-sectional study. The study participants underwent a complete blood count test, analysis for lipid profile, and carotid ultrasound. The patients were divided into 5 groups depending on CAS degree: none; 20%-49%; 50%-69%; 70%-99%; and occlusion. Results Data from 2548 patients were included in the final analysis (mean age: 57.9 ± 12.3 years; 51% males [n = 1301]). The analysis confirmed the relationship between the increase in the RDW index and CAS gradation increase in men (Kr-W H = 16.43; P = 0.0009), but was not confirmed in women (Kr-W H = 4.32; P = 0.22). Significantly higher levels of high-density lipoprotein cholesterol and platelets and lower levels of red blood cell and white blood cells were registered in female patients without CAS and with CAS < 50% compared with men (P < 0.001). Conclusion The results of the present study showed that RDW is an indicator whose increase is associated with an increase in the degree of carotid atherosclerosis in men, but not in women. This allows to discuss the role of the RDW index as a possible new laboratory biomarker of inflammation and progression of atherosclerosis, which can make an additional contribution to the formation of increased morbidity and mortality in men from atherosclerotic CVD.
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Affiliation(s)
- Oleg Gaisenok
- Department of Internal Medicine and Cardiology, United Hospital with Outpatient Clinic, Moscow, Russia
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Timóteo AT, Ribeiras R, Gavina C, Cabral S, Almeida AG, António N, Calé R, Moura B, Franco F, Ilhão Moreira R, Gonçalves L. Perceptions of cardiology, professional preferences and impact on career choices among Portuguese cardiologists: Results from the Portuguese Society of Cardiology's Women and Cardiology Task Force survey. Rev Port Cardiol 2024; 43:189-199. [PMID: 37866503 DOI: 10.1016/j.repc.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/27/2023] [Indexed: 10/24/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Cardiology has not been seen as an attractive specialty, and women have avoided it for many years. Some surveys have been performed in other countries, but in Portugal, the situation is largely unknown. METHODS An online survey on perceptions of cardiology and professional preferences was sent to 1371 members of the Portuguese Society of Cardiology, of whom 18.2% completed the survey. RESULTS We included 219 cardiologists or cardiology trainees, of whom 50.2% were female, with decreasing proportions from younger to older age groups, in which males still predominate. Women are less often married and more frequently childless, particularly those working in an invasive subspecialty, where they represent only 16% of all respondents working in these areas. Men's perception is that women do not choose these areas due to family reasons, radiation concerns and difficult working conditions, but from the female perspective, male dominance, lack of female role models and restricted access are the main barriers. Women consider it is difficult for them to obtain a leadership role, but men do not think the same (75.5% vs. 27.5%). CONCLUSION In Portugal, females predominate in younger age groups, suggesting a paradigm change. Women are less frequently married and more frequently childless, particularly women working in invasive subspecialties. Women consider that it is more difficult for them to obtain a leadership role. Moreover, the barriers reported by women are substantially different from men regarding the reasons for not choosing an invasive subspecialty.
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Affiliation(s)
- Ana Teresa Timóteo
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal; NOVA Medical School, Lisboa, Portugal.
| | - Regina Ribeiras
- Hospital de Santa Cruz, Centro Hospitalar Universitário Lisboa Ocidental, Lisboa, Portugal; Hospital da Luz Lisboa, Lisboa, Portugal
| | - Cristina Gavina
- Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Sociedade Portuguesa de Cardiologia, Portugal
| | - Sofia Cabral
- Sociedade Portuguesa de Cardiologia, Portugal; Hospital Geral de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Ana G Almeida
- Hospital de Santa Maria, Centro Hospitalar e Universitário de Lisboa Norte, Lisboa, Portugal; Faculdade de Medicina da Universidade de Lisboa, CCUL, Lisboa, Portugal
| | - Natália António
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - Rita Calé
- Hospital Garcia Orta, Almada, Portugal; Associação Portuguesa Intervenção Coronária (APIC) da Sociedade Portuguesa de Cardiologia, Portugal
| | - Brenda Moura
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Hospital Forças Armadas - Pólo do Porto, Porto, Portugal
| | - Fátima Franco
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - Rita Ilhão Moreira
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal; NOVA Medical School, Lisboa, Portugal
| | - Lino Gonçalves
- Sociedade Portuguesa de Cardiologia, Portugal; Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
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Duarte F, Dourado R, Barradas MI, Calado D, Felgueiras Ó, Martins D. Heart surgery waiting list management in an ultra-peripheral region: impact of a risk-stratified queuing method. Acta Cardiol 2024:1-9. [PMID: 38529843 DOI: 10.1080/00015385.2024.2330029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 03/06/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND The management of heart surgery waiting list is essential, particularly in ultraperipheral regions. We aimed to characterise a cohort of patients awaiting surgery in such a region, and to assess the occurrence of adverse events and causative factors. METHODS A retrospective, multicentre analysis from 2016 to 2020. Patients were divided into "Urgent group" vs "Priority group" based on surgical priority. A composite outcome of death or hospital admission was determined. RESULTS We included 329 patients, 18.2% in the Urgent group. Baseline characteristics were similar, except for a higher prevalence of smoking habits in the Urgent group (56.7% vs 38.7%, p = 0.016), as well as the CCS class (p = 0.014) and EuroScore surgical risk (p < 0.001). Disease acuity indicated highest priority for coronary artery bypass grafting patients. Myocardial revascularization and aortic valvular replacement were the main procedures. Overall, 15.2% of patients received treatment within recommended waiting time, with 50.8% being Urgent patients. Urgent patients had higher risk for composite outcome (HR 3.92, 95% CI 1.26-12.22; p = 0.019), with fewer events reported (5% vs 17.8%, p = 0.051). Chronic kidney disease and previous open-heart surgery were independent predictors of this outcome. Chronic kidney disease remained as independent predictor at 1-year follow-up, while surgical priority did not affect outcomes. CONCLUSIONS Despite similar occurrences of adverse events on the waiting list, longer waiting times for patients in the Urgent group increase their risk of adverse events. The priority level had no impact on outcomes. Chronic kidney disease and open-heart surgery were independent predictors for events, highlighting their significance in the triage process.
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Affiliation(s)
- Fabiana Duarte
- Cardiology Department, Hospital of Divino Espírito Santo of Ponta Delgada, São Miguel island, Azores, Portugal
| | - Raquel Dourado
- Cardiology Department, Hospital of Divino Espírito Santo of Ponta Delgada, São Miguel island, Azores, Portugal
| | - Maria Inês Barradas
- Cardiology Department, Hospital of Divino Espírito Santo of Ponta Delgada, São Miguel island, Azores, Portugal
| | - Daniel Calado
- Internal Medicine Department, Hospital of Divino Espírito Santo of Ponta Delgada, São Miguel island, Azores, Portugal
| | - Óscar Felgueiras
- Department of Mathematics, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Dinis Martins
- Cardiology Department, Hospital of Divino Espírito Santo of Ponta Delgada, São Miguel island, Azores, Portugal
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Yeh RW, Shlofmitz R, Moses J, Bachinsky W, Dohad S, Rudick S, Stoler R, Jefferson BK, Nicholson W, Altman J, Bateman C, Krishnaswamy A, Grantham JA, Zidar FJ, Marso SP, Tremmel JA, Grines C, Ahmed MI, Latib A, Tehrani B, Abbott JD, Batchelor W, Underwood P, Allocco DJ, Kirtane AJ. Paclitaxel-Coated Balloon vs Uncoated Balloon for Coronary In-Stent Restenosis: The AGENT IDE Randomized Clinical Trial. JAMA 2024; 331:1015-1024. [PMID: 38460161 PMCID: PMC10924708 DOI: 10.1001/jama.2024.1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/30/2024] [Indexed: 03/11/2024]
Abstract
Importance Drug-coated balloons offer a potentially beneficial treatment strategy for the management of coronary in-stent restenosis. However, none have been previously evaluated or approved for use in coronary circulation in the United States. Objective To evaluate whether a paclitaxel-coated balloon is superior to an uncoated balloon in patients with in-stent restenosis undergoing percutaneous coronary intervention. Design, Setting, and Participants AGENT IDE, a multicenter randomized clinical trial, enrolled 600 patients with in-stent restenosis (lesion length <26 mm and reference vessel diameter >2.0 mm to ≤4.0 mm) at 40 centers across the United States between May 2021 and August 2022. One-year clinical follow-up was completed on October 2, 2023. Interventions Participants were randomized in a 2:1 allocation to undergo treatment with a paclitaxel-coated (n = 406) or an uncoated (n = 194) balloon. Main Outcomes and Measures The primary end point of 1-year target lesion failure-defined as the composite of ischemia-driven target lesion revascularization, target vessel-related myocardial infarction, or cardiac death-was tested for superiority. Results Among 600 randomized patients (mean age, 68 years; 157 females [26.2%]; 42 Black [7%], 35 Hispanic [6%] individuals), 574 (95.7%) completed 1-year follow-up. The primary end point at 1 year occurred in 17.9% in the paclitaxel-coated balloon group vs 28.6% in the uncoated balloon group, meeting the criteria for superiority (hazard ratio [HR], 0.59 [95% CI, 0.42-0.84]; 2-sided P = .003). Target lesion revascularization (13.0% vs 24.7%; HR, 0.50 [95% CI, 0.34-0.74]; P = .001) and target vessel-related myocardial infarction (5.8% vs 11.1%; HR, 0.51 [95% CI, 0.28-0.92]; P = .02) occurred less frequently among patients treated with paclitaxel-coated balloon. The rate of cardiac death was 2.9% vs 1.6% (HR, 1.75 [95% CI, 0.49-6.28]; P = .38) in the coated vs uncoated balloon groups, respectively. Conclusions and Relevance Among patients undergoing coronary angioplasty for in-stent restenosis, a paclitaxel-coated balloon was superior to an uncoated balloon with respect to the composite end point of target lesion failure. Paclitaxel-coated balloons are an effective treatment option for patients with coronary in-stent restenosis. Trial Registration ClinicalTrials.gov Identifier: NCT04647253.
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Affiliation(s)
- Robert W. Yeh
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | - Jeffrey Moses
- Columbia University Irving Medical Center/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
| | | | - Suhail Dohad
- Cedars Sinai Medical Center, Los Angeles, California
| | - Steven Rudick
- Lindner Center for Research and Education at Christ Hospital, Cincinnati, Ohio
| | - Robert Stoler
- Baylor Scott & White Heart and Vascular Hospital, Dallas, Texas
| | | | | | | | | | | | | | | | - Steven P. Marso
- Overland Park Regional Medical Center, Overland Park, Kansas
| | | | - Cindy Grines
- Northside Hospital Cardiovascular Institute, Atlanta, Georgia
| | | | - Azeem Latib
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Behnam Tehrani
- The Inova Schar Heart and Vascular Institute, Falls Church, Virginia
| | - J. Dawn Abbott
- Lifespan Cardiovascular Institute, Rhode Island Hospital, Providence
| | - Wayne Batchelor
- The Inova Schar Heart and Vascular Institute, Falls Church, Virginia
| | | | | | - Ajay J. Kirtane
- Columbia University Irving Medical Center/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
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Verzelloni P, Urbano T, Wise LA, Vinceti M, Filippini T. Cadmium exposure and cardiovascular disease risk: A systematic review and dose-response meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123462. [PMID: 38295933 DOI: 10.1016/j.envpol.2024.123462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/30/2023] [Accepted: 01/27/2024] [Indexed: 02/05/2024]
Abstract
Exposure to toxic metals is a global public health threat. Among other adverse effects, exposure to the heavy metal cadmium has been associated with greater risk of cardiovascular disease (CVD). Nonetheless, the shape of the association between cadmium exposure and CVD risk is not clear. This systematic review summarizes data on the association between cadmium exposure and risk of CVD using a dose-response approach. We carried out a literature search in PubMed, Web of Science, and Embase from inception to December 30, 2023. Inclusion criteria were: studies on adult populations, assessment of cadmium exposure, risk of overall CVD and main CVD subgroups as endpoints, and observational study design (cohort, cross-sectional, or case-control). We retrieved 26 eligible studies published during 2005-2023, measuring cadmium exposure mainly in urine and whole blood. In a dose-response meta-analysis using the one-stage method within a random-effects model, we observed a positive association between cadmium exposure and risk of overall CVD. When using whole blood cadmium as a biomarker, the association with overall CVD risk was linear, yielding a risk ratio (RR) of 2.58 (95 % confidence interval-CI 1.78-3.74) at 1 μg/L. When using urinary cadmium as a biomarker, the association was linear until 0.5 μg/g creatinine (RR = 2.79, 95 % CI 1.26-6.16), after which risk plateaued. We found similar patterns of association of cadmium exposure with overall CVD mortality and risks of heart failure, coronary heart disease, and overall stroke, whereas for ischemic stroke there was a positive association with mortality only. Overall, our results suggest that cadmium exposure, whether measured in urine or whole blood, is associated with increased CVD risk, further highlighting the importance of reducing environmental pollution from this heavy metal.
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Affiliation(s)
- Pietro Verzelloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Teresa Urbano
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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Bagetta G, Corasaniti MT, Scuteri D. Epigenetic and nanotechnology alliance to fight stroke-induced brain damage. MOLECULAR THERAPY. NUCLEIC ACIDS 2024; 35:102150. [PMID: 38439913 PMCID: PMC10910111 DOI: 10.1016/j.omtn.2024.102150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Affiliation(s)
- Giacinto Bagetta
- Department of Pharmacy Health Science and Nutrition, University of Calabria, 87036 Rende, Italy
| | | | - Damiana Scuteri
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
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Beattie JM, Castiello T, Jaarsma T. The Importance of Cultural Awareness in the Management of Heart Failure: A Narrative Review. Vasc Health Risk Manag 2024; 20:109-123. [PMID: 38495057 PMCID: PMC10944309 DOI: 10.2147/vhrm.s392636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/27/2024] [Indexed: 03/19/2024] Open
Abstract
Heart failure is a commonly encountered clinical syndrome arising from a range of etiologic cardiovascular diseases and manifests in a phenotypic spectrum of varying degrees of systolic and diastolic ventricular dysfunction. Those affected by this life-limiting illness are subject to an array of burdensome symptoms, poor quality of life, prognostic uncertainty, and a relatively onerous and increasingly complex treatment regimen. This condition occurs in epidemic proportions worldwide, and given the demographic trend in societal ageing, the prevalence of heart failure is only likely to increase. The marked upturn in international migration has generated other demographic changes in recent years, and it is evident that we are living and working in ever more ethnically and culturally diverse communities. Professionals treating those with heart failure are now dealing with a much more culturally disparate clinical cohort. Given that the heart failure disease trajectory is unique to each individual, these clinicians need to ensure that their proposed treatment options and responses to the inevitable crises intrinsic to this condition are in keeping with the culturally determined values, preferences, and worldviews of these patients and their families. In this narrative review, we describe the importance of cultural awareness across a range of themes relevant to heart failure management and emphasize the centrality of cultural competence as the basis of appropriate care provision.
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Affiliation(s)
- James M Beattie
- School of Cardiovascular Medicine and Sciences, King’s College London, London, UK
- Department of Palliative Care and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
| | - Teresa Castiello
- Department of Cardiology, Croydon University Hospital, London, UK
- Department of Cardiovascular Imaging, King’s College London, London, UK
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Nursing Science, Julius Center, University Medical Center Utrecht, Utrecht, the Netherlands
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46
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Affiliation(s)
- Aleksandra Kostina
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr, East Lansing, Michigan, 48823, USA
- Department of Biomedical Engineering, College of Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan, 48823, USA
| | - Brett Volmert
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr, East Lansing, Michigan, 48823, USA
- Department of Biomedical Engineering, College of Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan, 48823, USA
| | - Aitor Aguirre
- Division of Developmental and Stem Cell Biology, Institute for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr, East Lansing, Michigan, 48823, USA
- Department of Biomedical Engineering, College of Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan, 48823, USA
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47
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Adorni R, Zanatta F, Cappelletti ER, Greco A, Steca P, D'Addario M. Effectiveness of a tailored communication intervention to improve physical activity in hypertensive patients: a twelve-month randomized controlled trial. BMC Cardiovasc Disord 2024; 24:143. [PMID: 38443805 PMCID: PMC10913652 DOI: 10.1186/s12872-024-03786-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality globally. Arterial hypertension is one of the main cardiovascular risk factors. Despite this, individuals with hypertension often fail to follow medical advice to counteract cardiovascular risks. A physically active lifestyle is one of the most challenging behaviors to adopt. This study aimed to preliminarily investigate the effectiveness of a tailored print message intervention to increase physical activity in patients with arterial hypertension. METHODS A sample of 188 patients with hypertension (mean age = 63 years; SD = 10.9; 50% men) participated in a theory-based tailored health communication intervention. Participants were randomly assigned to three parallel groups: (1) the tailored group, which received tailored health brochures; (2) the non-tailored group, which received non-tailored health brochures; or (3) the usual care group, which received no informative print materials. The longitudinal physical activity trajectories (baseline, 6- and 12-month follow-ups) were examined using repeated measures ANOVA and growth curve models. RESULTS At the baseline, 38.8% of patients achieved the target physical activity. This percentage rose to 43.0% at 6-month follow-up and 46.0% at 12-month follow-up. The descriptive statistics divided in function of the experimental group suggested differences in the longitudinal trend of the mean physical activity depending on the experimental group. However, statistical significance using repeated measures ANOVA did not support this observation. The analysis of the growth curves suggested that the tailored group showed a progressive increase in physical activity over twelve months (the model that best described the longitudinal trajectory was a linear growth model). The non-tailored group showed an increase in physical activity six months after the beginning of the intervention, followed by a decrease (free time score model). The usual care group did not change over time (no-growth model). CONCLUSIONS Findings suggest the effectiveness of the tailored intervention proposed. However, further investigations and empirical confirmations are required. TRIAL REGISTRATION ISRCTN13415993 ( https://doi.org/10.1186/ISRCTN13415993 ). Registration date: 08/04/2019.
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Affiliation(s)
- Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
| | | | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, 24129, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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Groen RA, Jukema JW, van Dijkman PRM, Bax JJ, Lamb HJ, Antoni ML, de Graaf MA. The Clear Value of Coronary Artery Calcification Evaluation on Non-Gated Chest Computed Tomography for Cardiac Risk Stratification. Cardiol Ther 2024; 13:69-87. [PMID: 38349434 PMCID: PMC10899125 DOI: 10.1007/s40119-024-00354-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024] Open
Abstract
To enhance risk stratification in patients suspected of coronary artery disease, the assessment of coronary artery calcium (CAC) could be incorporated, especially when CAC can be readily assessed on previously performed non-gated chest computed tomography (CT). Guidelines recommend reporting on patients' extent of CAC on these non-cardiac directed exams and various studies have shown the diagnostic and prognostic value. However, this method is still little applied, and no current consensus exists in clinical practice. This review aims to point out the clinical utility of different kinds of CAC assessment on non-gated CTs. It demonstrates that these scans indeed represent a merely untapped and underestimated resource for risk stratification in patients with stable chest pain or an increased risk of cardiovascular events. To our knowledge, this is the first review to describe the clinical utility of different kinds of visual CAC evaluation on non-gated unenhanced chest CT. Various methods of CAC assessment on non-gated CT are discussed and compared in terms of diagnostic and prognostic value. Furthermore, the application of these non-gated CT scans in the general practice of cardiology is discussed. The clinical utility of coronary calcium assessed on non-gated chest CT, according to the current literature, is evident. This resource of information for cardiac risk stratification needs no specific requirements for scan protocol, and is radiation-free and cost-free. However, some gaps in research remain. In conclusion, the integration of CAC on non-gated chest CT in general cardiology should be promoted and research on this method should be encouraged.
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Affiliation(s)
- Roos A Groen
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands.
- Netherlands Heart Institute, Utrecht, The Netherlands.
| | - Paul R M van Dijkman
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
| | - M Louisa Antoni
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
| | - Michiel A de Graaf
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA, Leiden, The Netherlands
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Krstačić G, Jülicher P, Krstačić A, Varounis C. A cost-effectiveness evaluation of a high-sensitivity troponin I guided voluntary cardiovascular risk assessment program for asymptomatic women in Croatia. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 20:200244. [PMID: 38476975 PMCID: PMC10928367 DOI: 10.1016/j.ijcrp.2024.200244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/23/2023] [Accepted: 01/31/2024] [Indexed: 03/14/2024]
Abstract
Background To estimate the effectiveness and cost-effectiveness of a high-sensitivity troponin I (hsTnI) guided cardiovascular risk assessment program in women in Croatia. Methods An observational study of a voluntary program for cardiovascular disease (CVD) risk assessment in women aged above 45 years with no specific symptoms, no confirmed or known coronary artery disease was conducted (WHP). Participants were stratified into three categories according to their hsTnI level. Subjects in the moderate or high-risk class were referred to cardiac work-up and invasive cardiovascular investigation as appropriate. Study information were applied to a discrete-event simulation model to estimate the cost-effectiveness of WHP against current practice. The number of CVD events and deaths, costs, and quality-adjusted life years (QALY) were assessed over 10 years from a societal perspective. Results Of 1034 women who participated in the program, 921 (89.1%), 100 (9.7%), and 13 (1.3%) subjects fall into the low, moderate, and high-risk class. Of 26 women referred for angiography, significant coronary artery disease (CAD) was diagnosed in 12 women (46.1%). WHP gained 15.8 (95%CI 12.8; 17.2) QALYs per 1000 subjects, increased costs by 490€ (95%CI 487; 500), decreased CVD-related mortality by 40%. At a willingness-to-pay threshold of 45,000 €/QALY, WHP was cost-effective with a probability of 90%. Model results were most sensitive to utility weights and cost of medical prevention. Conclusions Assessing the cardiovascular risk in asymptomatic women with hsTnI and guiding those at higher risk to further cardiac testing, identified individuals with CAD, could reduce CVD related burden, and would be cost-effective.
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Affiliation(s)
- Goran Krstačić
- Institute for Cardiovascular Prevention and Rehabilitation (Srčana), Zagreb, Croatia
- J. J. Strossmayer University of Osijek Faculty of Dental Medicine and Health, Osijek, Croatia
- J. J. Strossmayer University of Osijek Faculty of Medicine, Osijek, Croatia
| | - Paul Jülicher
- Medical Affairs, Core Diagnostics, Abbott, Abbott Park, IL, USA
| | - Antonija Krstačić
- J. J. Strossmayer University of Osijek Faculty of Dental Medicine and Health, Osijek, Croatia
- J. J. Strossmayer University of Osijek Faculty of Medicine, Osijek, Croatia
- University Hospital Center Sisters of Mercy, Zagreb, Croatia
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Morvaridzadeh M, Zoubdane N, Heshmati J, Alami M, Berrougui H, Khalil A. High-Density Lipoprotein Metabolism and Function in Cardiovascular Diseases: What about Aging and Diet Effects? Nutrients 2024; 16:653. [PMID: 38474781 DOI: 10.3390/nu16050653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Cardiovascular diseases (CVDs) have become the leading global cause of mortality, prompting a heightened focus on identifying precise indicators for their assessment and treatment. In this perspective, the plasma levels of HDL have emerged as a pivotal focus, given the demonstrable correlation between plasma levels and cardiovascular events, rendering them a noteworthy biomarker. However, it is crucial to acknowledge that HDLs, while intricate, are not presently a direct therapeutic target, necessitating a more nuanced understanding of their dynamic remodeling throughout their life cycle. HDLs exhibit several anti-atherosclerotic properties that define their functionality. This functionality of HDLs, which is independent of their concentration, may be impaired in certain risk factors for CVD. Moreover, because HDLs are dynamic parameters, in which HDL particles present different atheroprotective properties, it remains difficult to interpret the association between HDL level and CVD risk. Besides the antioxidant and anti-inflammatory activities of HDLs, their capacity to mediate cholesterol efflux, a key metric of HDL functionality, represents the main anti-atherosclerotic property of HDL. In this review, we will discuss the HDL components and HDL structure that may affect their functionality and we will review the mechanism by which HDL mediates cholesterol efflux. We will give a brief examination of the effects of aging and diet on HDL structure and function.
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Affiliation(s)
- Mojgan Morvaridzadeh
- Department of Medicine, Geriatric Service, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 4N4, Canada
| | - Nada Zoubdane
- Department of Medicine, Geriatric Service, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 4N4, Canada
| | - Javad Heshmati
- Department of Medicine, Geriatric Service, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 4N4, Canada
| | - Mehdi Alami
- Department of Medicine, Geriatric Service, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 4N4, Canada
| | - Hicham Berrougui
- Department of Medicine, Geriatric Service, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 4N4, Canada
| | - Abdelouahed Khalil
- Department of Medicine, Geriatric Service, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 4N4, Canada
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