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Hua Y, Zhang J, Liu Q, Su J, Zhao Y, Zheng G, Yang Z, Zhuo D, Ma C, Fan G. The Induction of Endothelial Autophagy and Its Role in the Development of Atherosclerosis. Front Cardiovasc Med 2022; 9:831847. [PMID: 35402552 PMCID: PMC8983858 DOI: 10.3389/fcvm.2022.831847] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/08/2022] [Indexed: 12/29/2022] Open
Abstract
Increasing attention is now being paid to the important role played by autophagic flux in maintaining normal blood vessel walls. Endothelial cell dysfunction initiates the development of atherosclerosis. In the endothelium, a variety of critical triggers ranging from shear stress to circulating blood lipids promote autophagy. Furthermore, emerging evidence links autophagy to a range of important physiological functions such as redox homeostasis, lipid metabolism, and the secretion of vasomodulatory substances that determine the life and death of endothelial cells. Thus, the promotion of autophagy in endothelial cells may have the potential for treating atherosclerosis. This paper reviews the role of endothelial cells in the pathogenesis of atherosclerosis and explores the molecular mechanisms involved in atherosclerosis development.
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Affiliation(s)
- Yunqing Hua
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jing Zhang
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qianqian Liu
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jing Su
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yun Zhao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guobin Zheng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zhihui Yang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Danping Zhuo
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chuanrui Ma
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guanwei Fan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Tianjin State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Qi Y, Wang S, Luo Y, Huang W, Chen L, Zhang Y, Liang X, Tang J, Zhang Y, Zhang L, Chao F, Gao Y, Zhu Y, Tang Y. Exercise-induced Nitric Oxide Contributes to Spatial Memory and Hippocampal Capillaries in Rats. Int J Sports Med 2020; 41:951-961. [PMID: 32643775 DOI: 10.1055/a-1195-2737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Exercise has been argued to improve cognitive function in both humans and rodents. Angiogenesis significantly contributes to brain health, including cognition. The hippocampus is a crucial brain region for cognitive function. However, studies quantifying the capillary changes in the hippocampus after running exercise are lacking. Moreover, the molecular details underlying the effects of running exercise remain poorly understood. We show that endogenous nitric oxide contributes to the beneficial effects of running exercise on cognition and hippocampal capillaries. Four weeks of running exercise significantly improved spatial memory ability and increased the number of capillaries in the cornu ammonis 1 subfield and dentate gyrus of Sprague-Dawley rats. Running exercise also significantly increased nitric oxide synthase activity and nitric oxide content in the rat hippocampus. After blocking the synthesis of endogenous nitric oxide by lateral ventricular injection of NG-nitro-L-arginine methyl ester, a nonspecific nitric oxide synthase inhibitor, the protective effect of running exercise on spatial memory was eliminated. The protective effect of running exercise on angiogenesis in the cornu ammonis 1 subfield and dentate gyrus of rats was also absent after nitric oxide synthase inhibition. Therefore, during running excise, endogenous nitric oxide may contribute to regulating spatial memory ability and angiogenesis in cornu ammonis 1 subfield and dentate gyrus of the hippocampus.
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Affiliation(s)
- Yingqiang Qi
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Sanrong Wang
- Department of Rehabilitation Medicine and Physical Therapy, Chongqing Medical University Affiliated Second Hospital, Chongqing, China
| | - Yanmin Luo
- Department of Physiology, Chongqing Medical University, Chongqing, China
| | - Wei Huang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Linmu Chen
- Department of Histology and Embryology, Shenzhen Children's Hospital, Shenzhen, China
| | - Yi Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Xin Liang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Jing Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Yang Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Lei Zhang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Fenglei Chao
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Yuan Gao
- Department of Geriatrics, Chongqing Medical University First Affiliated Hospital, Chongqing, China
| | - Yanqing Zhu
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
| | - Yong Tang
- Department of Histology and Embryology, Chongqing Medical University, Chongqing, China.,Laboratory of Stem Cells and Tissue Engineering, Chongqing Medical University, Chongqing, China
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El-Mahdy MA, Abdelghany TM, Hemann C, Ewees MG, Mahgoup EM, Eid MS, Shalaan MT, Alzarie YA, Zweier JL. Chronic cigarette smoke exposure triggers a vicious cycle of leukocyte and endothelial-mediated oxidant stress that results in vascular dysfunction. Am J Physiol Heart Circ Physiol 2020; 319:H51-H65. [PMID: 32412791 DOI: 10.1152/ajpheart.00657.2019] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although there is a strong association between cigarette smoking exposure (CSE) and vascular endothelial dysfunction (VED), the underlying mechanisms by which CSE triggers VED remain unclear. Therefore, studies were performed to define these mechanisms using a chronic mouse model of cigarette smoking (CS)-induced cardiovascular disease mirroring that in humans. C57BL/6 male mice were subjected to CSE for up to 48 wk. CSE impaired acetylcholine (ACh)-induced relaxation of aortic and mesenteric segments and triggered hypertension, with mean arterial blood pressure at 32 and 48 wk of exposure of 122 ± 6 and 135 ± 5 mmHg compared with 99 ± 4 and 102 ± 6 mmHg, respectively, in air-exposed mice. CSE led to monocyte activation with superoxide generation in blood exiting the pulmonary circulation. Macrophage infiltration with concomitant increase in NADPH oxidase subunits p22phox and gp91phox was seen in aortas of CS-exposed mice at 16 wk, with further increase out to 48 wk. Associated with this, increased superoxide production was detected that decreased with Nox inhibition. Tetrahydrobiopterin was progressively depleted in CS-exposed mice but not in air-exposed controls, resulting in endothelial nitric oxide synthase (eNOS) uncoupling and secondary superoxide generation. CSE led to a time-dependent decrease in eNOS and Akt expression and phosphorylation. Overall, CSE induces vascular monocyte infiltration with increased NADPH oxidase-mediated reactive oxygen species generation and depletes the eNOS cofactor tetrahydrobiopterin, uncoupling eNOS and triggering a vicious cycle of oxidative stress with VED and hypertension. Our study provides important insights toward understanding the process by which smoking contributes to the genesis of cardiovascular disease and identifies biomarkers predictive of disease.NEW & NOTEWORTHY In a chronic model of smoking-induced cardiovascular disease, we define underlying mechanisms of smoking-induced vascular endothelial dysfunction (VED). Smoking exposure triggered VED and hypertension and led to vascular macrophage infiltration with concomitant increase in superoxide and NADPH oxidase levels as early as 16 wk of exposure. This oxidative stress was accompanied by tetrahydrobiopterin depletion, resulting in endothelial nitric oxide synthase uncoupling with further superoxide generation triggering a vicious cycle of oxidative stress and VED.
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Affiliation(s)
- Mohamed A El-Mahdy
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Tamer M Abdelghany
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio.,Department of Pharmacology and Toxicology, College of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Craig Hemann
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Mohamed G Ewees
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio.,Department of Pharmacology and Toxicology, College of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Elsayed M Mahgoup
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio.,Department of Pharmacology and Toxicology, College of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mahmoud S Eid
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio.,Department of Pharmacology and Toxicology, College of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mahmoud T Shalaan
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio.,Department of Pharmacology and Toxicology, College of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Yasmin A Alzarie
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio.,Department of Pharmacology and Toxicology, College of Pharmacy, Helwan University, National Organization of Drug Control and Research, Cairo, Egypt
| | - Jay L Zweier
- Division of Cardiovascular Medicine, Department of Internal Medicine, Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, Ohio
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Xie S, Jiang R, Xu W, Chen Y, Tang L, Li L, Li P. The relationship between serum-free insulin- like growth factor-1 and metabolic syndrome in school adolescents of northeast China. Diabetes Metab Syndr Obes 2019; 12:305-313. [PMID: 30881074 PMCID: PMC6408198 DOI: 10.2147/dmso.s195625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Free insulin-like growth factor-1 (IGF-1) ratio (the ratio of IGF-1/insulin-like growth factor binding protein-3 [IGFBP-3]) was shown to be negatively correlated with metabolic syndrome (MetS) in adults, but it was unknown in Chinese adolescents. PATIENTS AND METHODS The cross-sectional study enrolled 701 healthy school students (aged 12-16 years, 46.1% females) and 93 of them (18-22 years old, 46.2% females) were followed after 5 years. RESULTS In the cross-sectional study, the IGF-1/IGFBP-3 ratios were found correlated with low-density lipoprotein cholesterol (LDL-C; r= -0.071, P<0.05) and diastolic blood pressure (r= -0.077, P=0.034). A lower IGF-1/IGFBP-3 ratio was an independent risk factor for MetS (OR =2.348, 95% CI: 1.040-5.303), hypertension (OR=1.729, 95% CI: 1.040-5.303), and increased LDL-C (OR=1.841, 95% CI: 1.230-2.755). In the follow-up study, all the participants were >18 years old. We found a lower baseline ratio of IGF-1/IGFBP-3 in adolescence was an independent risk factor for MetS in adulthood (OR=10.724, 95% CI: 1.032-11.403) and also indicated a higher body mass index (β=-1.361, 95% CI: -2.513 to -0.208) after 5 years. CONCLUSION The lower IGF-1/IGFBP-3 ratio was an independent risk factor for MetS, hypertension, and high LDL-C in adolescents of northeast China and was also a predictive marker for MetS and increased body mass index in the adulthood.
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Affiliation(s)
- Shuang Xie
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
- Department of General Medicine (VIP ward), Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning Province, P.R. China
| | - Ranhua Jiang
- Department of Endocrinology, Liaoyang Diabetes Hospital, Liaoyang, Liaoning Province, P.R. China
| | - Wanfeng Xu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| | - Yu Chen
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| | - Lei Tang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| | - Ling Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, P.R. China,
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Kałka D, Gebala J, Rusiecki L, Smoliński R, Dulanowski J, Rusiecka M, Biełous-Wilk A, Pilecki W, Womperski K, Zdrojowy R. Relation of Postexercise Reduction of Arterial Blood Pressure and Erectile Dysfunction in Patients with Coronary Heart Disease. Am J Cardiol 2018; 122:229-234. [PMID: 29751956 DOI: 10.1016/j.amjcard.2018.03.368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 12/23/2022]
Abstract
Penile erection is a hemodynamic process consisting of 2 synchronized components in which the first (active) requires proper vascular endothelium functioning, whereas the second one (passive) is based on a veno-occlusive mechanism. Antihypertensive treatment reduces the passive component, often leading to the development of erectile dysfunction (ED), but lifestyle modifications can improve the sexual functioning. The study aimed to evaluate the association between blood pressure (BP) reduction caused by cardiovascular training and the intensity of ED in men with coronary heart disease. A total of 101 men (mean age 59.50 ± 7.93) with ED treated invasively for coronary heart disease and subjected to cardiac rehabilitation were enrolled. Patient characteristics, the International Index of Erectile Function 5 (IIEF-5) questionnaire (IIEF-5), and BP values were collected at baseline and after 6 months of cardiac rehabilitation and were analyzed. Cardiac rehabilitation led to a significant reduction of 5.08 mm Hg in systolic BP (p <0.001) and of 1.60 mm Hg in diastolic BP (p <0.001). The IIEF-5 score (EQ) significantly increased (median 15, interquartile range 11 to 19 vs median 18, interquartile range 12 to 21, p <0.001). Greater improvement in sexual performance was significantly negatively correlated with age, concentration of triglycerides, and high-density lipoprotein, whereas it was positively correlated with the presence of diabetes and baseline IIEF-5 score. After excluding patients with diabetes, a greater decrease in systolic BP was found to be significantly associated with greater improvement in erectile performance. In conclusion, a reduction of arterial BP caused by cardiac training is accompanied by improvement in erectile performance. This effect is the strongest in patients with hypertension and those with dyslipidemia.
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Ho JS, Cannaday JJ, FitzGerald SJ, Leonard D, Finley CE, Wade WA, Reinhardt DB, Ellis JR, Barlow CE, Haskell WL, Defina LF, Gibbons LW, Cooper KH. Relation of Coronary Artery Diameters With Cardiorespiratory Fitness. Am J Cardiol 2018; 121:1065-1071. [PMID: 29502792 DOI: 10.1016/j.amjcard.2018.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 01/04/2018] [Accepted: 01/08/2018] [Indexed: 12/14/2022]
Abstract
Cardiorespiratory fitness is associated with reduced cardiovascular morbidity and mortality when adjusted for traditional risk factors. Mechanisms by which fitness reduces risk have been studied but remain incompletely understood. We hypothesize that higher fitness is associated with larger coronary artery diameters independent of its effect on traditional risk factors. Two independent measurements of the proximal diameters of the left main, left anterior descending, left circumflex, and right coronary arteries were obtained from gated multidetector computed tomography scans in 500 men from the Cooper Center Longitudinal Study (CCLS). Men with coronary artery calcium scores ≥10 were excluded. Fitness was measured with a maximal exercise treadmill test and reported by quintiles and as a function of METs. We then evaluated the relation between coronary artery diameters and fitness using mixed effect regression models. Higher fitness was associated with larger coronary artery diameters after adjustment for body surface area, smoking status, low-density lipoprotein and high-density lipoprotein cholesterol, resting systolic blood pressure, and serum glucose. When examined continuously, each MET increase in fitness was associated with a mean 0.03 ± 0.01 mm larger diameter of the left main, a 0.04 ± 0.01 mm larger diameter of the left anterior descending, a 0.05 ± 0.01 mm larger diameter of the left circumflex, and a 0.07 ± 0.01 mm larger diameter of the right coronary artery (p = 0.002). This correlation between fitness and coronary artery diameters was most prominent for fitness levels above 10 METs. In conclusion, higher fitness is associated with larger coronary artery diameters.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - William L Haskell
- Stanford Prevention Research Center, Stanford University, Stanford, California
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Charrin E, Dubé JJ, Connes P, Pialoux V, Ghosh S, Faes C, Ofori-Acquah SF, Martin C. Moderate exercise training decreases inflammation in transgenic sickle cell mice. Blood Cells Mol Dis 2018. [DOI: 10.1016/j.bcmd.2017.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bulut EC, Abueid L, Ercan F, Süleymanoğlu S, Ağırbaşlı M, Yeğen BÇ. Treatment with oestrogen-receptor agonists or oxytocin in conjunction with exercise protects against myocardial infarction in ovariectomized rats. Exp Physiol 2018; 101:612-27. [PMID: 26958805 DOI: 10.1113/ep085708] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/04/2016] [Indexed: 01/23/2023]
Abstract
NEW FINDINGS What is the central question of this study? Could the activation of oxytocin or oestrogen receptors be protective against myocardial injury after ovariectomy? If so, would exercising have an additional ameliorating effect? What is the main finding and its importance? The results revealed that when accompanied by exercise, both oestrogen receptor agonists and oxytocin improved cardiac dysfunction, inhibited the generation of pro-inflammatory cytokines and reduced myocardial injury in ovariectomized female rats, suggesting a new approach for protecting postmenopausal women against ischaemia-induced myocardial injury. To investigate the putative protective effects of oxytocin or oestrogen receptor agonists against myocardial injury of ovariectomized sedentary or exercised rats, female Sprague-Dawley rats assigned to sham-operated control and ovariectomized (OVX) groups were kept sedentary or undertook swimming exercise for 4 weeks and were treated with saline, an oestrogen receptor (ER) β (DPN) or ERα agonist (PPT) or oxytocin. Ovariectomy increased weight gain and anxiety in sedentary rats, whereas exercise prevented weight gain. When accompanied by exercise, both ER agonists and oxytocin inhibited weight gain and anxiety; oxytocin, in the absence or presence of exercise, increased the left ventricular diastolic dimensions and ejection fraction, whereas ER agonists also increased left ventricular diameter when given to exercised rats. Upon the induction of myocardial ischaemia-reperfusion in the OVX rats, plasma creatine kinase-(muscle-brain) was depressed by PPT and oxytocin, whereas DPN, PPT and OT reduced plasminogen activator inhibitor-1 concentrations. The increased tumour necrosis factor-α concentration in OVX rats was also suppressed by exercise or DPN, PPT or oxytocin treatments, whereas the interleukin-6 concentration was diminished by all the treatments when given in conjunction with exercise. Disorganization of cardiac muscle fibres was reduced in all exercised rats. Oestrogen receptor agonists, as well as oxytocin, in conjunction with exercise may be effective new therapeutics to protect against myocardial ischaemia in postmenopausal women.
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Affiliation(s)
- Erman Caner Bulut
- Department of Physiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Leyla Abueid
- Department of Physiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Feriha Ercan
- Department of Histology & Embryology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Selami Süleymanoğlu
- Department of Pediatric Cardiology, Gulhane Military Medical Academy, Istanbul, Turkey
| | - Mehmet Ağırbaşlı
- Department of Cardiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Berrak Ç Yeğen
- Department of Physiology, School of Medicine, Marmara University, Istanbul, Turkey
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Hodges GJ, Mallette MM, Tew GA, Saxton JM, Moss J, Ruddock AD, Klonizakis M. Effect of age on cutaneous vasomotor responses during local skin heating. Microvasc Res 2017; 112:47-52. [DOI: 10.1016/j.mvr.2017.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/06/2017] [Accepted: 03/06/2017] [Indexed: 12/19/2022]
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van Laar C, TImman ST, Noyez L. Decreased physical activity is a predictor for a complicated recovery post cardiac surgery. Health Qual Life Outcomes 2017; 15:5. [PMID: 28069013 PMCID: PMC5220604 DOI: 10.1186/s12955-016-0576-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 12/09/2016] [Indexed: 01/15/2023] Open
Abstract
Background Physical activity (PA) reduces the risk of cardiovascular disease and physically active survivors of a cardiac event are at lower risk of recurrent events. We hypothesized that patients with a decreased PA, undergoing cardiac surgery, are at higher risk for a postoperative complicated recovery (PCR). Methods Three thousand three hundred eighty two patients undergoing elective cardiac surgery between January 2007 and December 2013 were included. The group was divided into three subgroups: group A, aged ≤ 65 years (N = 1329); group B, aged > 65 years and ≤ 75 years (N = 1250); and group C aged >75 years (N = 803). To assess PA, the criteria of the Corpus Christy Heart Project were used. A PCR consists of the occurrence of a major postoperative event, defined as any of the following complications: reoperation, deep sternal wound infection, renal failure, stroke, postoperative ventilation > 2 days, intensive care stay ≥ 5 days, hospital stay ≥ 10 days, or hospital mortality. Results One thousand three hundred sixty seven patients (40%) were considered as patients with a decreased PA. Both in group B (p = 0.001) and in group C (p = 0.003), patients with a decreased PA were significantly associated with an increased risk of a PCR, which was not the case in group A (p = 0.28). Logistic regression analysis identified a decreased PA as an independent predictor for PCR in groups B (p = 0.003, odds 1.71) and C (p = 0.033, odds 1.48), but not in group A (p = 0.11, odds 0.71). Conclusion Decreased physical activity is an independent predictor for a PCR in patients aged 65 years or older undergoing elective cardiac surgery.
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Affiliation(s)
- Charlotte van Laar
- Department of Cardio-Thoracic Surgery - 615, Heart Center, Radboud University Nijmegen Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Simone T TImman
- Department of Cardio-Thoracic Surgery - 615, Heart Center, Radboud University Nijmegen Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Luc Noyez
- Department of Cardio-Thoracic Surgery - 615, Heart Center, Radboud University Nijmegen Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
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Liu H, Waite LJ, Shen S, Wang DH. Is Sex Good for Your Health? A National Study on Partnered Sexuality and Cardiovascular Risk among Older Men and Women. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:276-96. [PMID: 27601406 PMCID: PMC5052677 DOI: 10.1177/0022146516661597] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Working from a social relationship and life course perspective, we provide generalizable population-based evidence on partnered sexuality linked to cardiovascular risk in later life using national longitudinal data from the National Social Life, Health and Aging Project (NSHAP) (N = 2,204). We consider characteristics of partnered sexuality of older men and women, particularly sexual activity and sexual quality, as they affect cardiovascular risk. Cardiovascular risk is defined as hypertension, rapid heart rate, elevated C-reactive protein (CRP), and general cardiovascular events. We find that older men are more likely to report being sexually active, having sex more often, and more enjoyably than are older women. Results from cross-lagged models suggest that high frequency of sex is positively related to later risk of cardiovascular events for men but not women, whereas good sexual quality seems to protect women but not men from cardiovascular risk in later life. We find no evidence that poor cardiovascular health interferes with later sexuality for either gender.
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Affiliation(s)
- Hui Liu
- Michigan State University, East Lansing, MI, USA
| | | | - Shannon Shen
- Michigan State University, East Lansing, MI, USA
| | - Donna H Wang
- Michigan State University, East Lansing, MI, USA
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Koegelenberg ASE, Smith W, Schutte R, Schutte AE. IGF-1 and NT-proBNP in a black and white population: The SABPA study. Eur J Clin Invest 2016; 46:795-803. [PMID: 27455178 DOI: 10.1111/eci.12663] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/21/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Black populations exhibit lower concentrations of the cardioprotective peptide, insulin-like growth factor-1 (IGF-1), and are more prone to develop hypertensive heart disease than whites. We therefore determined whether lower IGF-1 in black individuals relates to a marker of cardiac overload and systolic dysfunction, namely N-terminal prohormone B-type natriuretic peptide (NT-proBNP). MATERIALS AND METHODS We included 160 black and 195 white nondiabetic South African men and women (aged 44·4 ± 9·81 years) and measured ambulatory blood pressure, NT-proBNP, IGF-1 and insulin-like growth factor-binding protein-3 (IGFBP-3). RESULTS Although the black group presented elevated ambulatory blood pressure accompanied by lower IGF-1 compared to the white group (all P < 0·001), we found similar NT-proBNP concentrations (P = 0·72). Furthermore, in blacks we found a link between NT-proBNP and systolic blood pressure (SBP) (R(2) = 0·37; β = 0·28; P < 0·001), but not with IGF-1. In the white group, NT-proBNP was inversely associated with IGF-1 (R(2) = 0·39; β = -0·22; P < 0·001) after adjusting for covariates and potential confounders. As IGF-1 is attenuated in diabetes, we added the initially excluded patients with diabetes (n = 38), and the aforementioned associations remained robust. CONCLUSION Contrary to the white group, we found no association between NT-proBNP and IGF-1 in black adults. Our findings suggest that SBP and other factors may play a greater contributory role in cardiac pathology in blacks.
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Affiliation(s)
- Anna S E Koegelenberg
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Rudolph Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Postgraduate Medical Institute, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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Koegelenberg A, Schutte R, Smith W, Schutte A. Bioavailable IGF-1 and its relationship with endothelial damage in a bi-ethnic population: The SABPA study. Thromb Res 2015; 136:1007-12. [DOI: 10.1016/j.thromres.2015.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/06/2015] [Accepted: 08/29/2015] [Indexed: 11/26/2022]
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Jorat M, Raafat S, Ansari Z, Mahdavi-Anari L, Ghanbari-Firoozabadi M. The Impact of Hospital-Based Cardiac Rehabilitation on Signal Average ECG Parameters of the Heart After Myocardial Infarction. Res Cardiovasc Med 2015; 4:e26353. [PMID: 26448915 PMCID: PMC4592540 DOI: 10.5812/cardiovascmed.26353v2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 04/11/2015] [Accepted: 04/19/2015] [Indexed: 11/17/2022] Open
Abstract
Background: Cardiac rehabilitation is a combination of integrated programs aimed at improving outcomes in patients recovering from heart events. Objectives: The present study aimed to evaluate the early benefits of supervised exercise training on electrophysiological function of post-ischemic myocardium. In this regard, signal-averaged electrocardiogram (SAECG) was used. Patients and Methods: Between May and September 2012, all patients (n = 100) admitted to our center, with the diagnosis of acute Myocardial Infarction (MI), were enrolled in this study. Every other patient was assigned to two groups receiving either inpatient cardiac rehabilitation plus standard post-MI care (cases) or only standard post-MI care (controls). Electrophysiological function was assessed by SAECG in all the patients at baseline and on the day 5. The patients were considered as having late potential if they had abnormalities in at least two SAECG indices. Results: Cardiac rehabilitation led to significant improvements in QRS duration (P < 0.001), square root of amplitude in the last 40 ms (P < 0.001) and duration of terminal signal with low amplitude (P < 0.001). Cardiac rehabilitation also resulted in amelioration of SAECG parameters; frequency of patients with late potential significantly decreased from 64% to 20% after five days (P < 0.001). Conclusions: Supervised in-hospital exercise training was associated with improvements in SAECG-measured electrical activity post-MI.
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Affiliation(s)
- Mohammadvahid Jorat
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Sina Raafat
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | - Zahra Ansari
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
- Corresponding author: Zahra Ansari, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran. Fax: +98-3535253335, E-mail:
| | - Leila Mahdavi-Anari
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
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16
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Cardiac rehabilitation and risk reduction: time to "rebrand and reinvigorate". J Am Coll Cardiol 2015; 65:389-395. [PMID: 25634839 DOI: 10.1016/j.jacc.2014.10.059] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 09/27/2014] [Accepted: 10/28/2014] [Indexed: 12/19/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) continues to increase annually in the United States along with its associated enormous costs. A multidisciplinary cardiac rehabilitation (CR) and risk reduction program is an essential component of ASCVD prevention and management. Despite the strong evidence for CR in the secondary prevention of ASCVD, it remains vastly underutilized due to significant barriers. The current model of CR delivery is unsustainable and needs significant improvement to provide cost-effective, patient-centered, comprehensive secondary ASCVD prevention.
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17
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Segedy AK, Pyle AL, Li B, Zhang Y, Babaev VR, Jat P, Fazio S, Atkinson JB, Linton MF, Young PP. Identification of small proline-rich repeat protein 3 as a novel atheroprotective factor that promotes adaptive Akt signaling in vascular smooth muscle cells. Arterioscler Thromb Vasc Biol 2014; 34:2527-36. [PMID: 25278290 DOI: 10.1161/atvbaha.114.303644] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Atherosclerosis is the primary driver of cardiovascular disease, the leading cause of death worldwide. Identification of naturally occurring atheroprotective genes has become a major goal for the development of interventions that will limit atheroma progression and associated adverse events. To this end, we have identified small proline-rich repeat protein (SPRR3) as selectively upregulated in vascular smooth muscle cells (VSMCs) of atheroma-bearing arterial tissue versus healthy arterial tissue. In this study, we sought to determine the role of SPRR3 in atheroma pathophysiology. APPROACH AND RESULTS We found that atheroprone apolipoprotein E-null mice lacking SPRR3 developed significantly greater atheroma burden. To determine the cellular driver(s) of this increase, we evaluated SPRR3-dependent changes in bone marrow-derived cells, endothelial cells, and VSMCs. Bone marrow transplant of SPRR3-expressing cells into SPRR3(-/-)apolipoprotein E-deficient recipients failed to rescue atheroma burden. Similarly, endothelial cells did not exhibit a response to SPRR3 loss. However, atheromas from SPRR3-deficient mice exhibited increased TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling)-positive VSMCs compared with control. Cell death in SPRR3-deficient VSMCs was significantly increased in vitro. Conversely, SPRR3-overexpressing VSMCs exhibited reduced apoptosis compared with control. We also observed a PI3K (phosphatidylinositol 3-kinase)/Akt-dependent positive association between SPRR3 expression and levels of active Akt in VSMCs. The survival advantage seen in SPRR3-overexpressing VSMCs was abrogated after the addition of a PI3K/Akt pathway inhibitor. CONCLUSIONS These results indicate that SPRR3 protects the lesion from VSMC loss by promoting survival signaling in plaque VSMCs, thereby significantly decreasing atherosclerosis progression. As the first identified atheroma-specific VSMC prosurvival factor, SPRR3 represents a potential target for lesion-specific modulation of VSMC survival.
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Affiliation(s)
- Amanda K Segedy
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - Amy L Pyle
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - Bin Li
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - Youmin Zhang
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - Vladimir R Babaev
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - Parmjit Jat
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - Sergio Fazio
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - James B Atkinson
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - MacRae F Linton
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.)
| | - Pampee P Young
- From the Department of Pathology, Microbiology, and Immunology (A.K.S., B.L., S.F., J.B.A., P.P.Y.) and Departments of Veterans Affairs Medical Center (J.B.A., P.P.Y.), Pharmacology (M.F.L.), and Medicine (Y.Z., V.R.B., S.F., M.F.L., P.P.Y.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurodegenerative Diseases, Institute of Neurology, University College London, Queen Square, London, United Kingdom (P.J.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH (A.L.P.); and Department of Pathology, The Ohio State University, Columbus (A.L.P.).
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18
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Hypertensive subjects with type-2 diabetes, the sympathetic nervous system, and treatment implications. Int J Cardiol 2014; 174:702-9. [DOI: 10.1016/j.ijcard.2014.04.204] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 04/19/2014] [Accepted: 04/19/2014] [Indexed: 11/19/2022]
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19
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Ricciardi AC, López-Cancio E, Pérez de la Ossa N, Sobrino T, Hernández-Pérez M, Gomis M, Munuera J, Muñoz L, Dorado L, Millán M, Dávalos A, Arenillas JF. Prestroke physical activity is associated with good functional outcome and arterial recanalization after stroke due to a large vessel occlusion. Cerebrovasc Dis 2014; 37:304-11. [PMID: 24851928 DOI: 10.1159/000360809] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 02/24/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although multiple studies and meta-analyses have consistently suggested that regular physical activity (PhA) is associated with a decreased stroke risk and recurrence, there is limited data on the possible preconditioning effect of prestroke PhA on stroke severity and prognosis. We aimed to study the association of prestroke PhA with different outcome variables in patients with acute ischemic stroke due to an anterior large vessel occlusion. METHODS The Prestroke Physical Activity and Functional Recovery in Patients with Ischemic Stroke and Arterial Occlusion trial is an observational and longitudinal study that included consecutive patients with acute ischemic stroke admitted to a single tertiary stroke center. Main inclusion criteria were: anterior circulation ischemic stroke within 12 h from symptom onset; presence of a confirmed anterior large vessel occlusion, and functional independence previous to stroke. Prestroke PhA was evaluated with the International Physical Activity Questionnaire and categorized into mild, moderate and high levels by means of metabolic equivalent (MET) minutes per week thresholds. The primary outcome measure was good functional outcome at 3 months (modified Rankin scale ≤2). Secondary outcomes were severity of stroke at admission, complete early recanalization, early dramatic neurological improvement and final infarct volume. RESULTS During the study period, 159 patients fulfilled the above criteria. The mean age was 68 years, 62% were men and the baseline NIHSS score was 17. Patients with high levels of prestroke PhA were younger, had more frequently distal occlusions and had lower levels of blood glucose and fibrinogen at admission. After multivariate analysis, a high level of prestroke PhA was associated with a good functional outcome at 3 months. Regarding secondary outcome variables and after adjustment for relevant factors, a high level of prestroke PhA was independently associated with milder stroke severity at admission, early dramatic improvement, early arterial recanalization after intravenous thrombolysis and lower final infarct volume. The beneficial association of prestroke PhA with stroke outcomes was already present with a cutoff point of 1,000 MET min/week, a level of PhA easily achieved by walking 1 h/day during 5 days or by doing a vigorous aerobic activity 1 h/day twice a week. CONCLUSIONS Prestroke PhA is independently associated with favorable stroke outcomes after a large vessel occlusion. Future research on the underlying mechanisms is needed to understand this neuroprotective effect of PhA.
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Affiliation(s)
- Ana Clara Ricciardi
- Stroke Unit, Department of Neurosciences, Germans Trias i Pujol University Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
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Kapustian L, Kroupskaya I, Rozhko O, Bobyk V, Ryabenko D, Sidorik L. Akt1 expression and activity at different stages in experimental heart failure. ACTA ACUST UNITED AC 2013; 21:147-51. [PMID: 24332918 DOI: 10.1016/j.pathophys.2013.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 11/16/2013] [Accepted: 11/19/2013] [Indexed: 11/17/2022]
Abstract
Loss of function or/and death of cardiomyocytes is one of the major contributing factors in the development of heart failure. Cytosolic Hsp60 can directly interact and regulate activation of some kinases and sequestrate certain proapoptotic molecules to avoid the cardiomyocyte apoptosis. We assumed that Akt1 kinase, a downstream effector of PI3 kinase, can interact with Hsp60. Our aim was to clarify the interaction of Akt1 and Hsp60 and to investigate the Akt1 expression in normal and failing hearts in acute and chronic stress. The experimental mouse models of inducible myocarditis and DCM-like pathology were developed in our laboratory. Akt1 and phospho-Akt1 (pS473) expression were studied by Western blot analysis. Co-immunoprecipitation method was used to test complex formation of Akt1 and Hsp60. The interaction of Hsp60 and Akt1 was detected for the first time by co-immunoprecipitation method in normal myocardium and under pathology as well. There were no significant changes in the level of Akt1 expression in both myocardia. At the same time we observed significant decrease in Akt1 phosphorylation at the final stage of DCM-like pathology but not at experimental myocarditis. The final stage of heart failure in mouse model of DCM-like pathology was characterized by reduced level of phospho-Akt1/Akt1 (pS473; -26%; P<0.05), whereas no differences were found in total Akt1 protein content. We suggest a possible involvement of cytoplasmic Hsp60 in regulation of Akt1 activity at heart failure progression.
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Affiliation(s)
- L Kapustian
- Institute of Molecular Biology and Genetics, NAS of Ukraine, 150, Zabolotnogo Str., Kyiv 03680, Ukraine.
| | - I Kroupskaya
- Institute of Molecular Biology and Genetics, NAS of Ukraine, 150, Zabolotnogo Str., Kyiv 03680, Ukraine
| | - O Rozhko
- Institute of Molecular Biology and Genetics, NAS of Ukraine, 150, Zabolotnogo Str., Kyiv 03680, Ukraine
| | - V Bobyk
- Institute of Molecular Biology and Genetics, NAS of Ukraine, 150, Zabolotnogo Str., Kyiv 03680, Ukraine
| | - D Ryabenko
- National Scientific Center "M. D. Strazhesko Institute of Cardiology, MAS of Ukraine", 5, Narodnogo Opolchenya Str., Kyiv 03151, Ukraine
| | - L Sidorik
- Institute of Molecular Biology and Genetics, NAS of Ukraine, 150, Zabolotnogo Str., Kyiv 03680, Ukraine
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Calvert JW, Lefer DJ. Role of β-adrenergic receptors and nitric oxide signaling in exercise-mediated cardioprotection. Physiology (Bethesda) 2013; 28:216-24. [PMID: 23817796 DOI: 10.1152/physiol.00011.2013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Exercise promotes cardioprotection in both humans and animals not only by reducing risk factors associated with cardiovascular disease but by reducing myocardial infarction and improving survival following ischemia. This article will define the role that nitric oxide and β-adrenergic receptors play in mediating the cardioprotective effects of exercise in the setting of ischemia-reperfusion injury.
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Affiliation(s)
- John W Calvert
- Department of Surgery, Division of Cardiothoracic Surgery, Carlyle Fraser Heart Center, Emory University School of Medicine, Atlanta, Georgia, USA.
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22
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Saxena A, Minton D, Lee DC, Sui X, Fayad R, Lavie CJ, Blair SN. Protective role of resting heart rate on all-cause and cardiovascular disease mortality. Mayo Clin Proc 2013; 88:1420-6. [PMID: 24290115 PMCID: PMC3908776 DOI: 10.1016/j.mayocp.2013.09.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/22/2013] [Accepted: 09/23/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To study the protective role of lower resting heart rate (RHR) in cardiovascular disease (CVD) and all-cause mortality. PATIENTS AND METHODS Patients (n=53,322) who received a baseline medical examination between January 1, 1974, and December 31, 2002, were recruited from the Cooper Clinic, Dallas, Texas. They completed a medical questionnaire and underwent clinical evaluation. Patients with CVD or cancer or who had less than 1 year of mortality follow-up were excluded from the study. Relative risks and 95% CIs for all-cause and CVD mortality across RHR categories were estimated using Cox proportional hazards models. RESULTS Highest cardiorespiratory fitness with lower mortality was found in individuals with an RHR of less than 60 beats/min. Similarly, patients with a higher RHR (≥80 beats/min) were at greater risk for CVD and all-cause mortality compared with an RHR of less than 60 beats/min. This analysis was followed by stratification of the data by hypertension, where hypertensive individuals with high RHRs (≥80 beats/min) were found to be at greater risk for CVD and all-cause mortality compared with those with hypertension and lower RHRs (<60 beats/min). In addition, unfit individuals with high RHRs had the greatest risk of CVD and all-cause mortality. The unfit with low RHR group had a similar risk for CVD and all-cause mortality as the fit with high RHR group. CONCLUSION Lower cardiorespiratory fitness levels and higher RHRs are linked to greater CVD and all-cause mortality.
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Affiliation(s)
- Arpit Saxena
- Department of Exercise Science, University of South Carolina, Columbia
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Suárez A, Guillamó E, Roig T, Blázquez A, Alegre J, Bermúdez J, Ventura JL, García-Quintana AM, Comella A, Segura R, Javierre C. Nitric oxide metabolite production during exercise in chronic fatigue syndrome: a case-control study. J Womens Health (Larchmt) 2012; 19:1073-7. [PMID: 20469961 DOI: 10.1089/jwh.2008.1255] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic fatigue syndrome (CFS) is a disabling illness of unknown etiology that is characterized by fatigue associated with a reduced ability to work, lasting for more than 6 months, and accompanied by a specific set of symptoms. The diagnosis remains difficult because of the absence of laboratory tests and is, therefore, made largely on the basis of the symptoms reported by the patient. The aim of this study was to analyze differences in blood nitrate levels in CFS patients and a matched control group after a physical exercise test. METHODS Forty-four consecutive female patients with CFS and 25 healthy women performed an exercise test using a cycle ergometer with monitoring of cardiopulmonary response. Blood samples were obtained for biochemical analyses of glucose, lactate, and nitrates at the beginning (under resting conditions) and after the maximal and supramaximal tests. RESULTS Plasma nitrates differed between the groups, with higher values in the CFS group (F = 6.93, p = 0.003). Nitrate concentration increased in relation to workload and reached higher values in the CFS group, the maximum difference with respect to the control group being 295% (t = 4.88, p < 0.001). CONCLUSIONS The main result of the present study is that nitric oxide (NO) metabolites (nitrates) showed a much higher increase after a maximal physical test in CFS patients than in a group of matched subjects. This combination (exercise plus NO response evaluation) may be useful in the assessment of CFS.
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Affiliation(s)
- Andrea Suárez
- Department of Physiological Sciences II, Medical School, University of Barcelona, L'Hospitalet, Barcelona, Spain
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Abstract
BACKGROUND Advances in medical and surgical care have contributed to an important increase in the survival rates of children with congenital heart disease. However, survivors often have decreased exercise capacity and health-related issues that affect their quality of life. Cardiac Rehabilitation Programmes have been extensively studied in adults with acquired heart disease. In contrast, studies of children with congenital heart disease have been few and of limited scope. We therefore undertook a systematic review of the literature on cardiac rehabilitation in children with congenital heart disease to systematically assess the current evidence regarding the use, efficacy, benefits, and risks associated with this therapy and to identify the components of a successful programme. METHODS We included studies that incorporated a cardiac rehabilitation programme with an exercise training component published between January, 1981 and November, 2010 in patients under 18 years of age. RESULTS A total of 16 clinical studies were found and were the focus of this review. Heterogeneous methodology and variable quality was observed. Aerobic and resistance training was the core component of most studies. Diverse variables were used to quantify outcomes. No adverse events were reported. CONCLUSIONS Cardiac Rehabilitation Programmes in the paediatric population are greatly underutilised, and clinical research on this promising form of therapy has been limited. Questions remain regarding the optimal structure and efficacy of the programmes. The complex needs of this unique population also mandate that additional outcome measures, beyond serial cardiopulmonary exercise testing, be identified and studied.
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Limb-specific training affects exercise hyperemia but not sympathetic vasoconstriction. Eur J Appl Physiol 2012; 112:3819-28. [PMID: 22391681 DOI: 10.1007/s00421-012-2359-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 02/14/2012] [Indexed: 01/22/2023]
Abstract
This study used cross-sectional and longitudinal training research designs to determine if (a) exercise hyperemia is enhanced in exercise-trained forearms and (b) sympathetic vasoconstriction of the trained forearm is attenuated (sympatholysis) during handgrip exercise. In the cross-sectional comparison, 10 rock climbers, 10 runners, 10 controls participated while the longitudinal training study examined vascular responsiveness in six untrained men before and after 6 weeks of handgrip training. Mean blood velocity, brachial artery diameter, heart rate, and systemic blood pressure were measured at rest, during a cold pressor test (CPT), dynamic handgrip exercise at 30% MVC with and without CPT, and during reactive hyperemia. During the resting CPT, forearm blood flow (FBF) decreased less (P < 0.05) in runners than in climbers, the decline being -6.30 + 30.05 and -34.3 + 20.54 during the last minute, respectively. During handgrip exercise, FBF and vascular conductance (VC) increased more (P < 0.05) in climbers than in runners and controls, the latter reaching 3.98 + 1.11, 2.22 + 0.88, and 2.75 + 1.06 ml min(-1) mmHg(-1), respectively. When a CPT was added during handgrip exercise, the reduction in FBF and VC was not different between the groups. Handgrip training increased (P < 0.05) forearm volume (5 + 3%) and MVC (25 + 29%), but did not affect FBF or VC during a CPT, with or without exercise. These data suggest that arm-trained athletes have greater exercise hyperemia. However, this training effect is not explained by sympatholysis and is not evident after 6 weeks of handgrip training in previously untrained subjects.
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Downing J, Balady GJ. The role of exercise training in heart failure. J Am Coll Cardiol 2011; 58:561-9. [PMID: 21798416 DOI: 10.1016/j.jacc.2011.04.020] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 04/12/2011] [Accepted: 04/19/2011] [Indexed: 12/25/2022]
Abstract
Exercise training in patients with systolic heart failure (HF) is an accepted adjunct to an evidence-based management program. This review describes the pathophysiologic features that are thought to be responsible for the exercise intolerance experienced in the HF patient. Significant research has expanded our appreciation of the interplay of hemodynamic, ventilatory, and skeletal myopathic processes in this common, chronic condition. Randomized, controlled exercise trials designed to measure endothelial function, inflammatory markers, sympathetic neural activation, and skeletal muscle metabolism and structure have further defined the pathophysiology, documented the impact of exercise training on these processes, and confirmed the benefit of this therapy. Consistent with prior clinical research and patient experience are the recently published results of the HF-ACTION (Heart Failure-A Controlled Trial Investigating Outcomes of exercise TraiNing), which demonstrated a modest improvement in exercise capacity, reduction of symptoms, and improved self-reported measures of quality of life without adverse events. Consideration is given in this review to the benefits of variable intensity programs and the addition of resistance exercise to a standard aerobic prescription. Despite increasing validation of the role exercise training plays in the modification of exercise intolerance, challenges remain in its routine therapeutic application, including acceptance and use as an adjunctive intervention in the management of the patient with HF, limited insurance coverage for HF patients in cardiac rehabilitation, tailoring of exercise programs to best address the needs of subgroups of patients, and improved short- and long-term adherence to exercise training and a physically active lifestyle.
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Affiliation(s)
- Jill Downing
- Section of Cardiology, Department of Medicine, Boston Medical Center and the Boston University School of Medicine, Boston, Massachusetts 02118, USA
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Sussman MA, Völkers M, Fischer K, Bailey B, Cottage CT, Din S, Gude N, Avitabile D, Alvarez R, Sundararaman B, Quijada P, Mason M, Konstandin MH, Malhowski A, Cheng Z, Khan M, McGregor M. Myocardial AKT: the omnipresent nexus. Physiol Rev 2011; 91:1023-70. [PMID: 21742795 PMCID: PMC3674828 DOI: 10.1152/physrev.00024.2010] [Citation(s) in RCA: 180] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
One of the greatest examples of integrated signal transduction is revealed by examination of effects mediated by AKT kinase in myocardial biology. Positioned at the intersection of multiple afferent and efferent signals, AKT exemplifies a molecular sensing node that coordinates dynamic responses of the cell in literally every aspect of biological responses. The balanced and nuanced nature of homeostatic signaling is particularly essential within the myocardial context, where regulation of survival, energy production, contractility, and response to pathological stress all flow through the nexus of AKT activation or repression. Equally important, the loss of regulated AKT activity is primarily the cause or consequence of pathological conditions leading to remodeling of the heart and eventual decompensation. This review presents an overview compendium of the complex world of myocardial AKT biology gleaned from more than a decade of research. Summarization of the widespread influence that AKT exerts upon myocardial responses leaves no doubt that the participation of AKT in molecular signaling will need to be reckoned with as a seemingly omnipresent regulator of myocardial molecular biological responses.
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Affiliation(s)
- Mark A Sussman
- Department of Biology, San Diego State University, SDSU Heart Institute, San Diego, California 92182, USA.
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Jakovljević VL, Zlatković M, Cubrilo D, Pantić I, Djurić DM. The effects of progressive exercise on cardiovascular function in elite athletes: focus on oxidative stress. ACTA ACUST UNITED AC 2011; 98:51-8. [PMID: 21388931 DOI: 10.1556/aphysiol.98.2011.1.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Some side-effects of excessive physical training are ascribed to reactive oxygen species production. In this work we investigated the effects of progressively imposed maximal physical effort (levels I to V), using progressive maximal exercise test, on peripheral blood lactate, NO (through NO2-), superoxide anion (O2-) and methemoglobin (MetHb) in a group of 19 elite soccer players. Blood lactate (mmol/L) was increased (4.55, level V vs. resting level, 1.95). The basal production of NO2- was in the direct relation with O2 consumption. Significant increase (p<0.05) in O2- values at effort level I (4.18) as compared to the resting value (4.01), and the significant increase (p<0.01 or p<0.05) in the MetHb (%) was found between II (18.79) and III (19.63) or between II and IV (19.24) effort levels, respectively. The regression lines of NO2- and O2- crossed at the level of the respiratory compensation point (RC), suggesting that RC could be of a crucial importance not only in the anaerobic and aerobic metabolism but in mechanisms of signal transductions as well. The results could be of the theoretical interest and also useful in designing an athlete training strategy.
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Affiliation(s)
- Vladimir Lj Jakovljević
- Department of Physiology, Faculty of Medicine, University of Kragujevac, Svetozara Markovica 69, P. P. 124, 34000 Kragujevac, Republic of Serbia.
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The estimation of GC repeats in promoter P1 of IGF-1 gene and their influence on IGF-1 plasma levels in stable angina patients. Protein J 2011; 29:524-9. [PMID: 20872173 PMCID: PMC2951508 DOI: 10.1007/s10930-010-9283-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Increased plasma levels of insulin-like growth factor 1 (IGF-1) are observed in advanced arteriosclerosis, but the reasons for these elevated levels remain unknown. One possibility to explain them is variation in the sequences that control IGF-1 gene expression. The goal of this study was to determine the effect of molecular variants of the IGF-1 P1 promoter on IGF-1 serum levels and to determine the impact of IGF-1 levels on the severity of coronary atherosclerosis. Methods: Blood samples were collected from 101 consecutive patients undergoing routine angiography. Genomic DNA was isolated from the nucleated cells of the blood plasma as described (2). Based on the presence of conformational differences in the DNA strand and on the absence of single nucleotide polymorphisms, the DNA from 38 patients was further analyzed by the “allelic ladder” method to determine the number of repeated GC dinucleotides in the P1 promoter of the IGF-1 gene. In addition, we analyzed serum growth hormone levels in order to examine the effect on systemic IGF-1 synthesis. Results: Conformational differences in the P1 promoter of the IGF-1 gene were observed in 38 out of the 101 patients. Several genotypes, depending on the number of GC repeats, were observed (11/19,17/19,18/19,18/21,19/19,19/20,19/21). Interestingly, a family history of coronary artery disease was seen less often among individuals heterozygous for the GC repeats. A lower IGF-1 levels were seen in non-variant carriers (homozygous genotypes for 19 or 21 repeats of GC, or heterozygous genotype 19/21) when compared to the variant group (other heterozygous genotypes then 19/21) (181.6 ± 47.9 ng/mL vs. 227.7 ± 73.7, p = 0.026). A correlation between IGF-1, IGF-binding protein number 3, and growth hormone levels (p = ns) was not observed, and there were no significant differences in the growth hormone levels in the studied group of patients (p = ns).
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Alkarmi A, Thijssen DHJ, Albouaini K, Cable NT, Wright DJ, Green DJ, Dawson EA. Arterial prehabilitation: can exercise induce changes in artery size and function that decrease complications of catheterization? Sports Med 2010; 40:481-92. [PMID: 20524713 DOI: 10.2165/11531950-000000000-00000] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Coronary angiography and angioplasty are common invasive procedures in cardiovascular medicine, which involve placement of a sheath inside peripheral conduit arteries. Sheath placement and catheterization can be associated with arterial thrombosis, spasm and occlusion. In this paper we review the literature pertaining to the possible benefits of arterial 'prehabilitation'--the concept that interventions aimed at enhancing arterial function and size (i.e. remodelling) should be undertaken prior to cardiac catheterization or artery harvest during bypass graft surgery. The incidence of artery spasm, occlusion and damage is lower in larger arteries with preserved endothelial function. We conclude that the beneficial effects of exercise training on both artery size and function, which are particularly evident in individuals who possess cardiovascular diseases or risk factors, infer that exercise training may reduce complication rates following catheterization and enhance the success of arteries harvested as bypass grafts. Future research efforts should focus directly on examination of the 'prehabilitation' hypothesis and the efficacy of different interventions aimed at reducing clinical complications of common interventional procedures.
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Affiliation(s)
- Amr Alkarmi
- Liverpool Heart and Chest Hospital, Liverpool, UK
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Negrao MV, Alves CR, Alves GB, Pereira AC, Dias RG, Laterza MC, Mota GF, Oliveira EM, Bassaneze V, Krieger JE, Negrao CE, Rondon MUPB. Exercise training improves muscle vasodilatation in individuals with T786C polymorphism of endothelial nitric oxide synthase gene. Physiol Genomics 2010; 42A:71-7. [DOI: 10.1152/physiolgenomics.00145.2009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Allele T at promoter region of the eNOS gene has been associated with an increase in coronary disease mortality, suggesting that this allele increases susceptibility for endothelial dysfunction. In contrast, exercise training improves endothelial function. Thus, we hypothesized that: 1) Muscle vasodilatation during exercise is attenuated in individuals homozygous for allele T, and 2) Exercise training improves muscle vasodilatation in response to exercise for TT genotype individuals. From 133 preselected healthy individuals genotyped for the T786C polymorphism, 72 participated in the study: TT ( n = 37; age 27 ± 1 yr) and CT+CC ( n = 35; age 26 ± 1 yr). Forearm blood flow (venous occlusion plethysmography) and blood pressure (oscillometric automatic cuff) were evaluated at rest and during 30% handgrip exercise. Exercise training consisted of three sessions per week for 18 wk, with intensity between anaerobic threshold and respiratory compensation point. Resting forearm vascular conductance (FVC, P = 0.17) and mean blood pressure ( P = 0.70) were similar between groups. However, FVC responses during handgrip exercise were significantly lower in TT individuals compared with CT+CC individuals (0.39 ± 0.12 vs. 1.08 ± 0.27 units, P = 0.01). Exercise training significantly increased peak VO2 in both groups, but resting FVC remained unchanged. This intervention significantly increased FVC response to handgrip exercise in TT individuals ( P = 0.03), but not in CT+CC individuals ( P = 0.49), leading to an equivalent FVC response between TT and CT+CC individuals (1.05 ± 0.18 vs. 1.59 ± 0.27 units, P = 0.27). In conclusion, exercise training improves muscle vasodilatation in response to exercise in TT genotype individuals, demonstrating that genetic variants influence the effects of interventions such as exercise training.
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Affiliation(s)
- Marcelo V. Negrao
- Heart Institute (InCor), University of São Paulo Medical School; and
| | - Cleber R. Alves
- Heart Institute (InCor), University of São Paulo Medical School; and
| | | | | | - Rodrigo G. Dias
- Heart Institute (InCor), University of São Paulo Medical School; and
| | - Mateus C. Laterza
- Heart Institute (InCor), University of São Paulo Medical School; and
| | - Gloria F. Mota
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Edilamar M. Oliveira
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | - Jose E. Krieger
- Heart Institute (InCor), University of São Paulo Medical School; and
| | - Carlos E. Negrao
- Heart Institute (InCor), University of São Paulo Medical School; and
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Florescu M, Stoicescu C, Magda S, Petcu I, Radu M, Palombo C, Cinteza M, Lichiardopol R, Vinereanu D. “Supranormal” Cardiac Function in Athletes Related to Better Arterial and Endothelial Function. Echocardiography 2010; 27:659-67. [PMID: 20412268 DOI: 10.1111/j.1540-8175.2009.01121.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Thijssen DHJ, Maiorana AJ, O’Driscoll G, Cable NT, Hopman MTE, Green DJ. Impact of inactivity and exercise on the vasculature in humans. Eur J Appl Physiol 2010; 108:845-75. [PMID: 19943061 PMCID: PMC2829129 DOI: 10.1007/s00421-009-1260-x] [Citation(s) in RCA: 209] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2009] [Indexed: 12/12/2022]
Abstract
The effects of inactivity and exercise training on established and novel cardiovascular risk factors are relatively modest and do not account for the impact of inactivity and exercise on vascular risk. We examine evidence that inactivity and exercise have direct effects on both vasculature function and structure in humans. Physical deconditioning is associated with enhanced vasoconstrictor tone and has profound and rapid effects on arterial remodelling in both large and smaller arteries. Evidence for an effect of deconditioning on vasodilator function is less consistent. Studies of the impact of exercise training suggest that both functional and structural remodelling adaptations occur and that the magnitude and time-course of these changes depends upon training duration and intensity and the vessel beds involved. Inactivity and exercise have direct "vascular deconditioning and conditioning" effects which likely modify cardiovascular risk.
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Affiliation(s)
- Dick H. J. Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Henry Cotton Campus, 15–21 Webster Street, Liverpool, L3 2ET UK
- Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Andrew J. Maiorana
- Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, Australia
- School of Physiotherapy, Curtin University of Technology, Perth, Australia
| | - Gerry O’Driscoll
- Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, Australia
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Nigel T. Cable
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Henry Cotton Campus, 15–21 Webster Street, Liverpool, L3 2ET UK
| | - Maria T. E. Hopman
- Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Daniel J. Green
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Henry Cotton Campus, 15–21 Webster Street, Liverpool, L3 2ET UK
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
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Tinken TM, Thijssen DHJ, Hopkins N, Dawson EA, Cable NT, Green DJ. Shear stress mediates endothelial adaptations to exercise training in humans. Hypertension 2010; 55:312-8. [PMID: 20048193 DOI: 10.1161/hypertensionaha.109.146282] [Citation(s) in RCA: 331] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Although episodic changes in shear stress have been proposed as the mechanism responsible for the effects of exercise training on the vasculature, this hypothesis has not been directly addressed in humans. We examined brachial artery flow-mediated dilation, an index of NO-mediated endothelial function, in healthy men in response to an acute bout of handgrip exercise and across an 8-week period of bilateral handgrip training. Shear stress responses were attenuated in one arm by cuff inflation to 60 mm Hg. Similar increases were observed in grip strength and forearm volume and girth in both limbs. Acute bouts of handgrip exercise increased shear rate (P<0.005) and flow-mediated dilation percentage (P<0.05) in the uncuffed limb, whereas no changes were evident in the cuffed arm. Handgrip training increased flow-mediated dilation percentage in the noncuffed limb at weeks 2, 4, and 6 (P<0.001), whereas no changes were observed in the cuffed arm. Brachial artery peak reactive hyperemia, an index of resistance artery remodeling, progressively increased with training in the noncuffed limb (P<0.001 and 0.004); no changes were evident in the cuffed arm. Neither acute nor chronic shear manipulation during exercise influenced endothelium-independent glyceryl trinitrate responses. These results demonstrate that exercise-induced changes in shear provide the principal physiological stimulus to adaptation in flow-mediated endothelial function and vascular remodeling in response to exercise training in healthy humans.
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Affiliation(s)
- Toni M Tinken
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
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Wagner L, Laczy B, Tamaskó M, Mazák I, Markó L, Molnár GA, Wagner Z, Mohás M, Cseh J, Fekete A, Wittmann I. Cigarette smoke-induced alterations in endothelial nitric oxide synthase phosphorylation: role of protein kinase C. ACTA ACUST UNITED AC 2008; 14:245-55. [PMID: 17922342 DOI: 10.1080/10623320701606707] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Endothelial nitric oxide synthase (eNOS) is regulated by phosphorylation of Ser(1177) and Thr(495), which affects NO bioavailability. Cigarette smoke disturbs the eNOS-cGMP-NO pathway and causes decreased NO production. Here the authors investigated the acute effects of cigarette smoke on eNOS phosphorylation, focusing on protein kinases (PKs). Endothelial cell culture was concentration- and time-dependently treated first with cigarette smoke buffer (CSB), then with reduced glutathione (GSH) or various PK inhibitors (H-89, LY-294002, Ro-318425, and ruboxistaurin). eNOS, phospho-Ser(1177)-eNOS, phospho-Thr(495)-eNOS, Akt(PKB), and phospho-Akt protein levels were determined by Western blot. CSB increased the phosphorylation of eNOS at Ser(1177) and more at Thr(495) in a concentration- and time-dependent manner (p < .01, p < .05 versus control, respectively) and resulted in the dissociation of the active dimeric form of eNOS (p < .05). GSH decreased the phosphorylation of eNOS at both sites (p < .05 versus CSB without GSH) and prevented the decrease of dimer eNOS level. CSB treatment also decreased the level of phospho-Ser(473)-Akt (p < .05 versus control). Inhibition of PKA by H-89 did not affect CSB-induced phosphorylation, whereas the PKB inhibitor LY-294002 enhanced it at Ser(1117). The PKC blockers Ro-318425 and ruboxistaurin augmented the CSB-induced phosphorylation at Ser(1177) but decreased phosphorylation at Thr(495) (p < .05 versus CSB). Cigarette smoke causes a disruption of the enzymatically active eNOS dimers and shifts the eNOS phosphorylation to an inhibitory state. Both effects might lead to reduced NO bioavailability. The shift of the eNOS phosphorylation pattern to an inhibitory state seems to be independent of the PKA and phosphoinositol 3-kinase (PI3-K)/Akt pathways, whereas PKC appears to play a key role.
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Affiliation(s)
- L Wagner
- 2nd Department of Medicine and Nephrological Center, Faculty of Medicine, University of Pécs, Pécs, Hungary
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Batzlsperger CA, Achatz S, Spreng J, Riegger GAJ, Griese DP. Evidence for a Possible Inhibitory Interaction between the HO-1/CO- and Akt/NO-Pathways in Human Endothelial Cells. Cardiovasc Drugs Ther 2007; 21:347-55. [PMID: 17896171 DOI: 10.1007/s10557-007-6051-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The protective properties of heme oxygenase 1 (HO-1) give reason to study this mechanism as a potential therapeutic target for inflammatory and cardiovascular diseases. Recent evidence suggests a possible interaction between the HO-1/CO- and the protein kinase Akt/NO-pathway. This study was designed to examine the effects of continuous HO-1 overexpression in endothelial cells. METHODS Oncoretroviral vectors were constructed to achieve constitutive overexpression of HO-1, Akt, and green fluorescence protein in human umbilical vein endothelial cells. [(3)H]thymidine-incorporation and lipid-peroxidation were measured following exposure to heme and H(2)O(2). Expression of HO-1, Akt and its downstream-target endothelial NO-synthase were quantified by Western blot analysis. NO-synthase-activity was measured using the citrulline-conversion-assay. RESULTS HO-1-overexpression reduced proliferative rates and DNA-synthesis of HUVEC, but provided potent protection from oxidative stress induced by heme and H(2)O(2). Phosphorylated-Akt and eNOS was downregulated in HO-1-HUVEC. eNOS-activity was reduced in HO-1-HUVEC. Co-infection with the Akt-retrovirus restored proliferative rates and eNOS-expression and -activity. CONCLUSION Continuously elevated HO-1-activity protects EC from oxidative stress but inhibits Akt-mediated proliferation and eNOS-expression. This inhibitory feedback mechanism could be a limitation of HO-1 as a target for the treatment of vascular disease.
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Affiliation(s)
- Christian A Batzlsperger
- Department of Internal Medicine II, Regensburg University Medical Center, Franz Josef Strauss Allee 11, 93053 Regensburg, Germany
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Casillas JM, Gremeaux V, Damak S, Feki A, Pérennou D. Exercise training for patients with cardiovascular disease. ACTA ACUST UNITED AC 2007; 50:403-18, 386-402. [PMID: 17445931 DOI: 10.1016/j.annrmp.2007.03.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Accepted: 03/09/2007] [Indexed: 01/19/2023]
Abstract
This review surveys effort training, a validated and recommended therapy, in patients with atheromatous cardiovascular disease. This true therapy reduces mortality by 25-35%, reduces clinical manifestations and complications (rhythm problems, thrombosis) and improves physical capacity, reintegration and quality of life. The effects are essentially linked to improved metabolic performance of muscles and reduced endothelial dysfunction, insulin resistance and neurohormonal abnormalities. Training also has an impact on the evolution of major risk factors, especially diabetes and arterial hypertension. The risks are limited as long as the contraindications are respected and the programmes supervised. The indications (stable angina, chronic heart failure, peripheral arterial disease) should be described more precisely by taking into account functional criteria: physical deconditioning, exclusion, compliance, mood swings, and seriousness of risk factors. The training programme should be tailor made and based on evaluation of the patient's adaptation to effort, in terms of frequency, intensity and duration of the exercises. Various types of exercise include overall or segmental physical training; concentric, eccentric, even isokinetic muscle contraction exercises; and proprioceptive rehabilitation. However, knowledge is lacking about the molecular mechanisms of the effects of training, the most effective intensity of effort, and strategies to develop physical activity in this ever-growing population for both primary and secondary prevention.
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Affiliation(s)
- J M Casillas
- Pôle rééducation-réadaptation, Inserm U887, CHU de Dijon, 23, rue Gaffarel, 21079 Dijon cedex, France.
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Abstract
Endothelial dysfunction not only precedes the development of significant coronary artery stenosis, it has also been identified as a general phenomenon predicting future cardiovascular events in patients who are at risk. As regular physical activity as a part of a multifactorial intervention has been shown to affect symptoms beneficially, increase myocardial perfusion and--most importantly--reduce mortality in patients with coronary heart disease or myocardial infarction, this review will elucidate potential mechanisms responsible for the improvement in survival as a result of regular physical activity. The importance of exercise training-mediated regression of coronary stenosis, collateral formation, correction of endothelial dysfunction including the adaptation at the molecular level, as well as vasculogenesis will be discussed as possible underlying key players, and their potential contribution to the training-induced survival benefit in patients with coronary heart disease will be critically evaluated.
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Affiliation(s)
- Sandra Erbs
- Department of Cardiology, University of Leipzig, Heart Center, Leipzig, Germany
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Pellegrin M, Berthelot A, Houdayer C, Gaume V, Deckert V, Laurant P. New insights into the vascular mechanisms underlying the beneficial effect of swimming training on the endothelial vasodilator function in apolipoprotein E-deficient mice. Atherosclerosis 2006; 190:35-42. [PMID: 16529753 DOI: 10.1016/j.atherosclerosis.2006.02.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Revised: 02/02/2006] [Accepted: 02/02/2006] [Indexed: 12/22/2022]
Abstract
The antiatherogenic role of exercise is poorly understood. We examined the swimming exercise-induced vascular mechanisms which enhance the endothelial vasodilator function in apoE(-/-) mice. Male apoE(-/-) mice treated for 9 weeks with a lipid-rich diet were divided into two groups: the exercise group (apoE(-/-) X), which underwent a 9-week swimming protocol (50 min/day; 5days/week) and the sedentary group (apoE(-/-) S). C57BL/6 mice were used as the control group. Atherosclerotic lesions in the aortic roots were significantly reduced in apoE(-/-) X compared to apoE(-/-) S. Relaxation to acetylcholine was improved in apoE(-/-) X as compared to apoE(-/-) S and control mice with E(max) and pD(2) values significantly higher. pD(2) values in response to papaverine were higher in apoE(-/-) X than in the other groups. Relaxation in response to A23187 and DEA-NONOate were similar. These findings suggest that swimming training may increase the sensitivity of relaxation to acetylcholine, which in turn activates acetylcholine-mediated signaling pathways leading to increased NO bioactivity. Swimming may also prolong the signaling actions of NO by stimulating the sensitivity of vascular smooth muscle cells to cyclic nucleotides. These appear to be the key mechanisms underlying the improvement of the NO-cGMP pathway in exercised apoE(-/-) mice.
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Affiliation(s)
- Maxime Pellegrin
- EA 3921 Optimisation Métabolique et Cellulaire, Université de Franche-Comté, UFR Médecine-Pharmacie/STAPS, place Saint Jacques, 25030 Besançon, France.
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Leighton F, Miranda-Rottmann S, Urquiaga I. A central role of eNOS in the protective effect of wine against metabolic syndrome. Cell Biochem Funct 2006; 24:291-8. [PMID: 16170835 DOI: 10.1002/cbf.1269] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The positive health effects derived from moderate wine consumption are pleiotropic. They appear as improvements in cardiovascular risk factors such as plasma lipids, haemostatic mechanisms, endothelial function and antioxidant defences. The active principles would be ethanol and mainly polyphenols. Results from our and other laboratories support the unifying hypothesis that the improvements in risk factors after red wine consumption are mediated by endothelial nitric oxide synthase (eNOS). Many genes are involved, but the participation of eNOS would be a constant feature. The metabolic syndrome is a cluster of metabolic risk factors associated with high risk of cardiovascular disease (CVD). The National Cholesterol Education Programmmes Adult Treatment Panel III (NCEPATP III) clinical definition of the metabolic syndrome requires the presence of at least three risk factors, from among abdominal obesity, high plasma triacylglycerols, low plasma HDL, high blood pressure and high fasting plasma glucose. The molecular mechanisms responsible for the metabolic syndrome are not known. Since metabolic syndrome apparently affects 10-30% of the population in the world, research on its pathogenesis and control is needed. The recent finding that eNOS knockout mice present a cluster of cardiovascular risk factors comparable to those of the metabolic syndrome suggests that defects in eNOS function may cause human metabolic syndrome. These mice are hypertensive, insulin resistant and dyslipidemic. Further support for a pathogenic role of eNOS comes from the finding in humans that eNOS polymorphisms associate with insulin resistance and diabetes, with hypertension, with inflammatory and oxidative stress markers and with albuminuria. So, the data sustain the hypothesis that eNOS enhancement should reduce metabolic syndrome incidence and its consequences. Therefore red wine, since it enhances eNOS function, should be considered as a potential tool for the control of metabolic syndrome. This hypothesis is supported by epidemiological observations and needs experimental validation in human intervention studies.
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Affiliation(s)
- Federico Leighton
- Laboratorio de Nutrición Molecular, Facultad de Ciencias Biológicas, Universidad Católica de Chile, Chile.
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Giovannelli F, Rubattu S. The Role of Cardiac Rehabilitation in the Treatment and Secondary Prevention of Cardiovascular Disease. High Blood Press Cardiovasc Prev 2006. [DOI: 10.2165/00151642-200613010-00004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Abstract
Stroke represents a leading cause of morbidity and mortality especially among the elderly people, and therefore the need for effective preventive strategies is imperative. The value of physical activity for stroke prevention is not as well established as for other cardiovascular diseases. Despite some conflicting results, the majority of published studies have demonstrated a negative association between physical activity and stroke risk. In this article, we provide a concise overview of the epidemiological studies that investigate this association as well as a comprehensive analysis of the most relevant underlying pathophysiological mechanisms.
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Affiliation(s)
- A Alevizos
- Health Center of Vyronas, Athens, Greece
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Abstract
Osteoporosis and atherosclerosis are both widely prevalent in an ageing population, and induce serious morbidities and death. There is growing evidence that in addition to their relationship to ageing, osteoporosis and atherosclerosis are also linked by biological associations. This article reviews their clinical interrelations, discusses the basic biology of bone and the arterial wall, and presents five examples that illustrate their biological linkages. Current therapeutic approaches emerging from these linkages, including statins, bisphosphonates, and the thiazolidinediones, have dual effects on bone and the vasculature. Additional therapies derived from experimental studies that enhance bone density and reduce atherogenesis hold further promise to diminish the morbidity and mortality of osteoporosis and atherosclerosis, with attendant benefits to society.
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Affiliation(s)
- D Hamerman
- Department of Medicine and Resnick Gerontology Center, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.
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45
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Conti E, Carrozza C, Capoluongo E, Volpe M, Crea F, Zuppi C, Andreotti F. Insulin-like growth factor-1 as a vascular protective factor. Circulation 2005; 110:2260-5. [PMID: 15477425 DOI: 10.1161/01.cir.0000144309.87183.fb] [Citation(s) in RCA: 178] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Elena Conti
- Department of Cardiovascular Diseases, Institute of Cardiology, Catholic University, Medical School, Via Todi 60, 00181 Rome, Italy.
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Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, Thompson PD, Williams MA, Lauer MS. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111:369-76. [PMID: 15668354 DOI: 10.1161/01.cir.0000151788.08740.5c] [Citation(s) in RCA: 596] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This article updates the 1994 American Heart Association scientific statement on cardiac rehabilitation. It provides a review of recommended components for an effective cardiac rehabilitation/secondary prevention program, alternative ways to deliver these services, recommended future research directions, and the rationale for each component of the rehabilitation/secondary prevention program, with emphasis on the exercise training component.
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Physical activity levels during phase IV cardiac rehabilitation in a group of male myocardial infarction patients. Br J Sports Med 2005; 39:e12; discussion e12. [PMID: 15728680 DOI: 10.1136/bjsm.2003.010983] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To determine physical activity levels during phase IV cardiac rehabilitation in 31 male myocardial infarction patients (median age 62, range 53-77 years). METHODS Patients recorded daily physical activity over 16 weeks in a diary. Diaries were analysed for total general physical activity (TGPA), leisure time physical activity (LTPA), and "active for life" exercise classes (AFL). Pre- and post-observation period (OP) subjects underwent a 10 m shuttle walking test (SWT) to determine changes in aerobic fitness. Rate of perceived exertion (RPE) determined exercise intensity. Estimated gross energy expenditure (EEE) was determined by a regression equation between RPE and Vo(2) (l min(-1)) during SWT. A total of 97% of subjects were on lipid lowering medication. RESULTS There were no correlations between Vo(2) (l min(-1)) and body mass, therefore kcal min(-1) indicated activity intensity. There were no significant changes in physical activity patterns or in aerobic fitness. Estimated total LTPA (median 1376, range 128-3380 kcal week(-1)) was less than that recommended to improve aerobic fitness and/or slow progression of coronary artery disease. Sixteen subjects attended a median of 29 (range 1-46) AFL during LTPA; one way ANOVA showed these subjects worked at greater EEE (AFL, n = 16, 6.6 (standard deviation 1.4) v no-AFL, n = 15, 5.1 (1.8) EEE kcal min(-1), p = 0.017). CONCLUSION Physical activity was stable, but patients' EEE appeared insufficient to improve aerobic fitness or slow progression of coronary artery disease. It was suggested that the promotion of LTPA and the availability of AFL classes should be reconsidered.
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Green DJ, Bilsborough W, Naylor LH, Reed C, Wright J, O'Driscoll G, Walsh JH. Comparison of forearm blood flow responses to incremental handgrip and cycle ergometer exercise: relative contribution of nitric oxide. J Physiol 2004; 562:617-28. [PMID: 15513940 PMCID: PMC1665516 DOI: 10.1113/jphysiol.2004.075929] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The contribution of endothelium-derived nitric oxide (NO) to exercise hyperaemia remains controversial. Disparate findings may, in part, be explained by different shear stress stimuli as a result of different types of exercise. We have directly compared forearm blood flow (FBF) responses to incremental handgrip and cycle ergometer exercise in 14 subjects (age +/-s.e.m.) using a novel software system which calculates conduit artery blood flow continuously across the cardiac cycle by synchronising automated edge-detection and wall tracking of high resolution B-mode arterial ultrasound images and Doppler waveform envelope analysis. Monomethyl arginine (L-NMMA) was infused during repeat bouts of each incremental exercise test to assess the contribution of NO to hyperaemic responses. During handgrip, mean FBF increased with workload (P < 0.01) whereas FBF decreased at lower cycle workloads (P < 0.05), before increasing at 120 W (P < 0.001). Differences in these patterns of mean FBF response to different exercise modalities were due to the influence of retrograde diastolic flow during cycling, which had a relatively larger impact on mean flows at lower workloads. Retrograde diastolic flow was negligible during handgrip. Although mean FBF was lower in response to cycling than handgrip exercise, the impact of L-NMMA was significant during the cycle modality only (P < 0.05), possibly reflecting the importance of an oscillatory antegrade/retrograde flow pattern on shear stress-mediated release of NO from the endothelium. In conclusion, different types of exercise present different haemodynamic stimuli to the endothelium, which may result in differential effects of shear stress on the vasculature.
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Affiliation(s)
- Daniel J Green
- School of Human Movement & Exercise Science, The University of Western Australia, Parkway Entrance No. 3, 35 Stirling Highway, Crawley WA 6009, Australia.
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Green DJ, Maiorana A, O'Driscoll G, Taylor R. Effect of exercise training on endothelium-derived nitric oxide function in humans. J Physiol 2004; 561:1-25. [PMID: 15375191 PMCID: PMC1665322 DOI: 10.1113/jphysiol.2004.068197] [Citation(s) in RCA: 637] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Vascular endothelial function is essential for maintenance of health of the vessel wall and for vasomotor control in both conduit and resistance vessels. These functions are due to the production of numerous autacoids, of which nitric oxide (NO) has been the most widely studied. Exercise training has been shown, in many animal and human studies, to augment endothelial, NO-dependent vasodilatation in both large and small vessels. The extent of the improvement in humans depends upon the muscle mass subjected to training; with forearm exercise, changes are restricted to the forearm vessels while lower body training can induce generalized benefit. Increased NO bioactivity with exercise training has been readily and consistently demonstrated in subjects with cardiovascular disease and risk factors, in whom antecedent endothelial dysfunction exists. These conditions may all be associated with increased oxygen free radicals which impact on NO synthase activity and with which NO reacts; repeated exercise and shear stress stimulation of NO bioactivity redresses this radical imbalance, hence leading to greater potential for autacoid bioavailability. Recent human studies also indicate that exercise training may improve endothelial function by up-regulating eNOS protein expression and phosphorylation. While improvement in NO vasodilator function has been less frequently found in healthy subjects, a higher level of training may lead to improvement. Regarding time course, studies indicate that short-term training increases NO bioactivity, which acts to homeostatically regulate the shear stress associated with exercise. Whilst the increase in NO bioactivity dissipates within weeks of training cessation, studies also indicate that if exercise is maintained, the short-term functional adaptation is succeeded by NO-dependent structural changes, leading to arterial remodelling and structural normalization of shear. Given the strong prognostic links between vascular structure, function and cardiovascular events, the implications of these findings are obvious, yet many unanswered questions remain, not only concerning the mechanisms responsible for NO bioactivity, the nature of the cellular effect and relevance of other autacoids, but also such practical questions as the optimal intensity, modality and volume of exercise training required in different populations.
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Affiliation(s)
- Daniel J Green
- School of Human Movement and Exercise Science, University of Western Australia, Mailbag Delivery M408, 35 Stirling Highway, Crawley WA 6009, Australia.
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Green DJ, Walsh JH, Maiorana A, Best MJ, Taylor RR, O'Driscoll JG. Exercise-induced improvement in endothelial dysfunction is not mediated by changes in CV risk factors: pooled analysis of diverse patient populations. Am J Physiol Heart Circ Physiol 2003; 285:H2679-87. [PMID: 12933344 DOI: 10.1152/ajpheart.00519.2003] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have pooled data from a series of our exercise training studies undertaken in groups with a broad range of vascular (dys) function to the examine the hypothesis that exercise-induced improvements in the conduit and/or resistance vessel function are related to improvements in risk factors for cardiovascular (CV) disease. Endothelium-dependent and -independent conduit vessel function were assessed by using wall tracking of high-resolution ultrasound images of the brachial artery response to flow-mediated dilation (FMD) and glyceryl trinitrate. Resistance vessel function was assessed using intrabrachial administration of acetylcholine (ACh), sodium nitroprusside, and NG-monomethyl-l-arginine. Randomized cross-over studies of 8-wk exercise training were undertaken in untreated hypercholesterolemic (n = 11), treated hypercholesterolemic (n = 11), coronary artery disease (n = 10), chronic heart failure (n = 12), Type 2 diabetic (n = 15), and healthy control subjects (n = 16). Exercise training did not significantly alter plasma lipids, blood pressure, blood glucose, waist-to-hip ratio, or body mass index values, despite significant improvement in both FMD and ACh responses. There were no correlations between changes in any risk factor variables and indexes of either resistance or conduit vessel function. We conclude that, in these subjects with antecedent vascular dysfunction, the beneficial effects of relatively short-term exercise training on vascular function are not solely mediated by the effects of exercise on CV risk factors.
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Affiliation(s)
- Daniel J Green
- School of Human Movement and Exercise Science, The University of Western Australia, and Department of Cardiology, Royal Perth Hospital, Crawley, Western Australia 6009, Australia
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