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Nasser R, Meyten N, Vermeersch P, Prihadi EA. When the solution becomes the problem: left atrial appendage occlusion device-related thrombus after 5 years. Eur Heart J 2021; 43:1015. [PMID: 34648618 DOI: 10.1093/eurheartj/ehab719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
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Nasser R, Fisher Y, Klein A. Gastrointestinal: Severe gastritis with complete gastric mucosal sloughing. J Gastroenterol Hepatol 2021; 36:2639. [PMID: 33624341 DOI: 10.1111/jgh.15427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/19/2021] [Accepted: 02/03/2021] [Indexed: 12/09/2022]
Affiliation(s)
- R Nasser
- Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Y Fisher
- Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - A Klein
- Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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Van Camp G, Beles M, Penicka M, Schelfaut D, Wouters S, De Raedt H, Wyffels E, Spapen J, Nasser R, Balogh Z, Albano M, De Beenhouwer H, Van Vaerenbergh K, Van Praet F, Degrieck I, Stockman B, Casselman F, Collet C. Importance of In-Hospital Prospective Registry and Infectious Endocarditis Heart Team to Monitor and Improve Quality of Care in Patients with Infectious Endocarditis. J Clin Med 2021; 10:jcm10173832. [PMID: 34501278 PMCID: PMC8432016 DOI: 10.3390/jcm10173832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/09/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Aim: To investigate the value of prospective in-hospital registry data and the impact of an infectious endocarditis heart team approach (IEHT) on improvement in quality of care and monitor outcomes in hospitalized patients with IE. Methods: Between December 2014 and the end of 2019, 160 patients were hospitalized in one centre with the definite diagnosis of infectious endocarditis (IE) and entered in a prospective registry. From 2017, an IEHT was introduced. Propensity score matching was used to assess the impact of an IEHT approach on clinical outcomes. Results: Median age was 72.5 y (62.75–80.00), diabetes was present in 33.1%, chronic kidney disease in 27.5%, COPD in 17.5%, and a history of ischaemic heart disease in 30.6%. Prosthetic valve IE was observed in 43.8% and device-related IE in 16.9% of patients. Staphylococcus (37.5%) was the most frequent pathogen followed by streptococcus (24.4%) and enterococcus (23.1%). Overall, 30-day and 1-year mortality were 19.4% and 37.5%, respectively. The introduction of prospective data collection and IE heart team was associated with a trend towards reduction of adjusted 1-year mortality (26.5% IEHT vs. 41.2% controls, p = 0.0699). An IEHT clinical decision-making approach was independently associated with a shorter length of stay (p = 0.04). Conclusions: Use of a prospective registry of IE coupled with a heart team approach was associated with more efficient patient management and a trend towards lower mortality. Prospective data collection and dedicated IEHT have the potential to improve patient care and clinical outcomes.
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Affiliation(s)
- Guy Van Camp
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
- Correspondence:
| | - Monika Beles
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
| | - Martin Penicka
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
| | - Dan Schelfaut
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
| | - Stijn Wouters
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
| | - Herbert De Raedt
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
| | - Eric Wyffels
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
| | - Jerrold Spapen
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
| | - Riwa Nasser
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
| | - Zsuzsanna Balogh
- Gottsegen Gyorgy National Institute of Cardilogy, Haller u. 29, 1096 Budapest, Hungary;
| | - Marzia Albano
- Cardiology Unit, S. Maria Nuova Hospital, Via Amendola 2, 42122 Reggio Emilia, Italy;
| | - Hans De Beenhouwer
- Department of Microbiology, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (H.D.B.); (K.V.V.)
| | | | - Frank Van Praet
- Cardiovascular and Thoracic Surgery, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (F.V.P.); (I.D.); (B.S.); (F.C.)
| | - Ivan Degrieck
- Cardiovascular and Thoracic Surgery, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (F.V.P.); (I.D.); (B.S.); (F.C.)
| | - Bernard Stockman
- Cardiovascular and Thoracic Surgery, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (F.V.P.); (I.D.); (B.S.); (F.C.)
| | - Filip Casselman
- Cardiovascular and Thoracic Surgery, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (F.V.P.); (I.D.); (B.S.); (F.C.)
| | - Carlos Collet
- Cardiovascular Center, OLV Aalst, Moorselbaan 164, 9300 Aalst, Belgium; (M.B.); (M.P.); (D.S.); (S.W.); (H.D.R.); (E.W.); (J.S.); (R.N.); (C.C.)
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Ooms JF, Bouwmeester S, Debonnaire P, Nasser R, Voigt JU, Schotborgh MA, Geleijnse ML, Kardys I, Spitzer E, Daemen J, De Jaegere PP, Houthuizen P, Swaans MJ, Dubois C, Claeys M, Van Der Heyden J, Tonino PA, Van Mieghem NM. Transcatheter Edge-to-Edge Repair in Proportionate Versus Disproportionate Functional Mitral Regurgitation. J Am Soc Echocardiogr 2021; 35:105-115.e8. [PMID: 34389469 DOI: 10.1016/j.echo.2021.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Functional mitral regurgitation (FMR) can be subclassified on the basis of its proportionality relative to left ventricular (LV) volume and function, indicating potential differences in underlying etiology. The aim of this study was to evaluate the association of FMR proportionality with FMR reduction, heart failure hospitalization and mortality after transcatheter edge-to-edge mitral valve repair (TEER). METHODS This multicenter registry included 241 patients with symptomatic heart failure with reduced LV ejection fraction treated with TEER for moderate to severe or greater FMR. FMR proportionality was graded on preprocedural transthoracic echocardiography using the ratio of the effective regurgitant orifice area to LV end-diastolic volume. Baseline characteristics, follow-up transthoracic echocardiography, and 2-year clinical outcomes were compared between groups. RESULTS Median LV ejection fraction, effective regurgitant orifice area and LV end-diastolic volume index were 30% (interquartile range [IQR], 25%-35%), 27 mm2, and 107 mL/m2 (IQR, 90-135 mL/m2), respectively. Median effective regurgitant orifice area/LV end-diastolic volume ratio was 0.13 (IQR, 0.10-0.18). Proportionate FMR (pFMR) and disproportionate FMR (dFMR) was present in 123 and 118 patients, respectively. Compared with patients with pFMR, those with dFMR had higher baseline LV ejection fractions (median, 32% [IQR, 27%-39%] vs 26% [IQR, 22%-33%]; P < .01). Early FMR reduction with TEER was more pronounced in patients with dFMR (odds ratio, 0.45; 95% CI, 0.28-0.74; P < .01) than those with pFMR, but not at 12 months (odds ratio, 0.93; 95% CI, 0.53-1.63; P = .80). Overall, in 35% of patients with initial FMR reduction after TEER, FMR deteriorated again at 1-year follow-up. Rates of 2-year all-cause mortality and heart failure hospitalization were 30% (n = 66) and 37% (n = 76), with no differences between dFMR and pFMR. CONCLUSIONS TEER resulted in more pronounced early FMR reduction in patients with dFMR compared with those with pFMR. Yet after initial improvement, FMR deteriorated in a substantial number of patients, calling into question durable mitral regurgitation reductions with TEER in selected patients. The proportionality framework may not identify durable TEER responders.
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Affiliation(s)
- Joris F Ooms
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | - Riwa Nasser
- University Hospital Antwerp, Antwerp, Belgium
| | | | | | - Marcel L Geleijnse
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Isabella Kardys
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ernest Spitzer
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Joost Daemen
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Peter P De Jaegere
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | | | - Marc Claeys
- University Hospital Antwerp, Antwerp, Belgium
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Nasser R, Vervloet T, Eckley CA, Amade S, Dokkedal-Silva V, Pires GN, Andersen ML, Tufik S, Longui C, Xavier SD. 0881 Clinical Evaluation of Adeno-Tonsillar Hyperplasia in Non-Syndromic Children and Adolescents During Growth Hormone Treatment. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Recombinant human Growth Hormone (rhGH) is an important pharmacological agent for linear growth stimulation and body composition in children with growth hormone deficiency (GHD). However, reports indicate that treatment with rhGH can be associated with adeno-tonsillar hyperplasia. This condition can lead to occurrence of obstructive sleep apnea (OSA) and worsening of sleep and life quality. Nonetheless, studies assessing this outcome in non-syndromic children are scarce.
Methods
We evaluated the difference in size of pharyngeal and palatine tonsils in patients aged between 5 and 17 being treated with recombinant human Growth Hormone (rhGH). We conducted a prospective longitudinal observational study. Twelve patients in treatment with rhGH were evaluated by otorhinolaryngological physical examination, nasofibrolaryngoscopy and obstructive sleep apnea (OSA)-18 questionnaire in two different time-points: when selected (T0) and after 6 months (T1).
Results
No significant associations were found regarding palatine and pharyngeal tonsil size with rhGH treatment. In relation to OSA 18 questionnaires, there was no statistically significant result in the absence of covariables for the general score as well as for the five domains that it comprises. When covariables were included in the analyses, controlled by the patients age, we observed statistically significant increases in the general score and in the domains relating to sleep disorders, emotional suffering, diurnal problems and the caretaker′s concerns.
Conclusion
In the present study, pharyngeal or palatine tonsils hyperplasia were infrequent during treatment with rhGH in the non-syndromic children and adolescents. However, the impact on sleep and quality of life that may arise warrant careful monitoring during therapy.
Support
Associação Fundo de Incentivo à Pesquisa (AFIP).
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Affiliation(s)
- R Nasser
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | - T Vervloet
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | - C A Eckley
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | - S Amade
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | | | - G N Pires
- Universidade Federal de Sao Paulo, Sao Paulo, BRAZIL
| | - M L Andersen
- Universidade Federal de Sao Paulo, Sao Paulo, BRAZIL
| | - S Tufik
- Universidade Federal de Sao Paulo, Sao Paulo, BRAZIL
| | - C Longui
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
| | - S D Xavier
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, BRAZIL
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Naffaa ME, Nasser R, Manassa E, Younis M, Azzam ZS, Aronson D. Cardiac troponin-I as a predictor of mortality in patients with first episode acute atrial fibrillation. QJM 2017; 110:507-511. [PMID: 28340049 DOI: 10.1093/qjmed/hcx060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent-onset atrial fibrillation (AF) is a frequent cause for presentation to the emergency department. Recent studies proposed that the addition of biomarker information might improve the prediction of clinical outcomes by enabling identification of patients at high risk. AIM We aimed to examine the role of cardiac troponin I as a predictor of clinical outcome in patients with first episode acute AF. DESIGN Patients, 18 years or older, presenting to our hospital with a primary diagnosis of first episode acute AF were included in this retrospective study. METHODS The association between elevated cTnI with mortality or the composite endpoint (mortality, stroke or heart failure) was examined in a univariate Cox regression model. RESULTS Of the 274 study patients, 111 had elevated cTnI levels (41%). Increased cTnI was associated with older age, history of myocardial infarction, higher creatinine levels and higher heart rate (All P < 0.01). Elevated cTn was associated with an adjusted hazard ratio of 1.86 [95% confidence interval (CI) 1.17-2.96; P = 0.009] for mortality and 1.89 (95% CI 1.27-2.84; P = 0.002) for the combined endpoint. CONCLUSIONS Elevated cardiac Troponin I is a significant predictor of mortality and a composite endpoint of mortality, stroke or heart failure in patients presenting with first episode acute AF.
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Affiliation(s)
- M E Naffaa
- Department of Internal Medicine "H", Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - R Nasser
- Department of Internal Medicine "B"
| | | | - M Younis
- Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Z S Azzam
- Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Department of Internal Medicine "B"
| | - D Aronson
- Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Division of Cardiology, Rambam Health Care Campus, Haifa, Israel
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7
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Kim EJ, Han JH, Koo HM, Doh FM, Kim CH, Ko KI, Lee MJ, Oh HJ, Yoo TH, Kang SW, Choi KH, Han SH, Assady S, Tchirkov M, Nasser R, Mashiach T, Ben Izhak O, Housset P, Guillemain R, Nochy D, Roland M, Amrein C, Karras A, Boussaud V, Pezzela V, Thervet E, Simic Ogrizovic SP, Basta Jovanovic G, Radojevic S, Bojic S, Naumovic R, Karim Z, Cyrine K, Rim G, Ezzeddine A, Hafedh H, Hayet K, Soumaya B, Mondher O, Fethi BH, Fethi EY, Taieb BA, Hedi BM, Fatma BM, Adel K, Housset P, Guillemain R, Roland M, Amrein C, Karras A, Boussaud V, Nochy D, Pezzela V, Thervet E, Penescu M, Mandache E, Zumrutdal A, Ozelsancak R, Canpolat T, Barbouch S, Mami I, Mayara M, Jerbi M, Harzallah A, Goucha R, Ben Maiz H, Kedher A, Comi N, Cianfrone P, Piraina V, Talarico R, Giannakakis K, Fuiano G, Lucisano G, Konat K, Szotowska M, Karkoszka H, Adamczak M, Wiecek A, Kwiecien K, Jercan O, Penescu M, Mogoanta L, Miller I, Pan X, Xu J, Ren H, Zhang W, Xu Y, Shen P, Chen X, Feng X, Chen N. Renal histopathology. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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8
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Nasser R, Taqueda M. Improvement of Filter Tow Quality through Statistical Analysis. Chem Eng Technol 2007. [DOI: 10.1002/ceat.200600301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Hagège H, Nasser R, Weber M, Milligan L, Aptel N, Jacquet C, Drewell RA, Dandolo L, Surani MA, Cathala G, Forné T. The 3' portion of the mouse H19 Imprinting-Control Region is required for proper tissue-specific expression of the Igf2 gene. Cytogenet Genome Res 2006; 113:230-7. [PMID: 16575185 DOI: 10.1159/000090837] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2005] [Accepted: 09/15/2005] [Indexed: 11/19/2022] Open
Abstract
Genomic imprinting at the H19/Igf2 locus is governed by a cis-acting Imprinting-Control Region (ICR), located 2 kb upstream of the H19 gene. This region possesses an insulator function which is activated on the unmethylated maternal allele through the binding of the CTCF factor. It has been previously reported that paternal transmission of the H19(SilK) deletion, which removes the 3' portion of H19 ICR, leads to the loss of H19 imprinting. Here we show that, in the liver, this reactivation of the paternal H19 gene is concomitant to a dramatic decrease in Igf2 mRNA levels. This deletion alters higher-order chromatin architecture, Igf2 promoter usage and tissue-specific expression. Therefore, when methylated, the 3' portion of the H19 ICR is a bi-functional regulatory element involved not only in H19 imprinting but also in 'formatting' the higher-order chromatin structure for proper tissue-specific expression of both H19 and Igf2 genes.
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Affiliation(s)
- H Hagège
- Institut de Génétique Moléculaire de Montpellier, Montpellier, France
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10
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Piatti PM, Monti LD, Valsecchi G, Conti M, Nasser R, Guazzini B, Fochesato E, Phan CV, Pontiroli AE, Pozza G. Effects of low-dose heparin infusion on arterial endothelin-1 release in humans. Circulation 1996; 94:2703-7. [PMID: 8941092 DOI: 10.1161/01.cir.94.11.2703] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of low-dose heparin infusion on arterialized endothelin-1 (ET-1) release in the presence of fasting or high insulin levels in healthy humans. METHODS AND RESULTS Eleven normal subjects underwent two tests in random order lasting 240 minutes. A primed (250 IU), continuous heparin (600 IU/h) infusion was performed in test 1; saline was infused in test 2 as control. At 120 minutes, a euglycemic hyperinsulinemic clamp (25 mU.kg-1.h-1) was started that lasted 2 hours in both tests. Two hours after heparin infusion (test 1), ET-1 levels decreased by 32% (3.52 +/- 0.60 to 3.02 +/- 0.73 pg/mL), while nitric oxide (NO) and forearm blood flow increased by 29% and 14%, respectively. During saline infusion, ET-1, nitric oxide, and forearm blood flow remained unchanged. There was a significant interaction between the effect of decreasing ET-1 levels and the heparin treatment (F, 4.06; df, 3.30; P < .01). The decrease in ET-1 levels was significantly correlated with the increase in forearm blood flow in test 1 (r = .74; P < .01) but not in test 2. During the heparin/insulin period, ET-1 increased by 25%, returning to fasting values; nitric oxide levels increased by 12%; and forearm blood flow remained unchanged. CONCLUSIONS The present study showed that it is possible to decrease ET-1 levels by use of low-dose heparin infusion in humans. This effect seems mediated by a simultaneous increase in nitric oxide levels and is completely reversed by a mild increase in insulin concentrations.
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Affiliation(s)
- P M Piatti
- Istituto Scientifico H. San Raffaele, Cattedra di Clinica Medica, University of Milan, Italy
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11
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Piatti PM, Monti LD, Baruffaldi L, Magni F, Paroni R, Fermo I, Costa S, Santambrogio G, Nasser R, Marchi M. Effects of an acute increase in plasma triglyceride levels on glucose metabolism in man. Metabolism 1995; 44:883-9. [PMID: 7616847 DOI: 10.1016/0026-0495(95)90241-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of the study was to evaluate the effects of an acute increase in triglyceride levels induced by Intralipid (Kabivitrum, Stockholm, Sweden) infusion on forearm glucose uptake, glucose oxidative metabolism, and hepatic glucose production independent of circulating free fatty acid (FFA) levels in man. Six normal subjects underwent three different tests in random order. Each test consisted of a control period of 120 minutes followed by a euglycemic, hyperinsulinemic clamp lasting 120 minutes. In test 1, a high-dose intravenous Intralipid infusion was performed to increase triglyceride and FFA levels. In test 2, heparin (30 U/min) plus low-dose Intralipid infusions were performed to maintain triglyceride at normal levels and increase only FFA levels. Test 3 was performed as a control study. During the 120-minute control period, forearm glucose uptake and hepatic glucose production were not affected by increasing only FFA levels (test 2) or FFA and triglyceride levels (test 1) as compared with the control study. On the contrary, glucose oxidation was significantly decreased as compared with the control study during tests 1 and 2, without a further significant decrease during simultaneously increased FFA and triglyceride levels. Concomitantly, lipid oxidation was similar in tests 1 and 2, at values significantly greater than in test 3. During the euglycemic clamp, forearm glucose uptake and glucose oxidation were significantly lower during tests 1 and 2 than test 3. At variance with the control period, the increase of triglyceride levels during test 1 caused a significant 30% to 40% decrease of both parameters as compared with test 2.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P M Piatti
- Istituto Scientifico H. San Raffaele, Milan, Italy
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12
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Piatti PM, Monti F, Fermo I, Baruffaldi L, Nasser R, Santambrogio G, Librenti MC, Galli-Kienle M, Pontiroli AE, Pozza G. Hypocaloric high-protein diet improves glucose oxidation and spares lean body mass: comparison to hypocaloric high-carbohydrate diet. Metabolism 1994; 43:1481-7. [PMID: 7990700 DOI: 10.1016/0026-0495(94)90005-1] [Citation(s) in RCA: 133] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The aim of the study was to investigate the effects of two hypocaloric (800-kcal) diets on body weight reduction and composition, insulin sensitivity, and proteolysis in 25 normal glucose-tolerant obese women. The two diets had the following composition: 45% protein, 35% carbohydrate (CHO), and 20% fat (HP diet, 10 subjects), and 60% CHO, 20% protein, and 20% fat (HC diet, 15 subjects); both lasted 21 days. A euglycemic hyperinsulinemic (25 mU/kg/h) clamp lasting 150 minutes combined with indirect calorimetry was performed before and after the diet. Both diets induced a similar decrease in body weight and fat mass (FM), whereas fat-free mass (FFM) decreased only after the HC diet. 3-Methylhistidine (3-CH3-HIS) excretion was reduced by 48% after the HP diet and remained unchanged after the HC diet (P < .05). A significant correlation was found between the changes in FFM and in 3-CH3-HIS excretion after the diet (rs = .50, P < .02). Blood glucose remained unchanged, while insulin decreased in both diets. Free fatty acids (FFA) significantly increased only after the HC diet (P < .05). During the clamp period, glucose disposal and glucose oxidation significantly increased after the HP diet and significantly decreased after the HC diet. Opposite results were found when measuring lipid oxidation. In conclusion, our experience suggests that (1) a hypocaloric diet providing a high percentage of natural protein can improve insulin sensitivity; and (2) conversely, a hypocaloric high-polysaccharide-CHO diet decreases insulin sensitivity and is unable to spare muscle tissue.
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Affiliation(s)
- P M Piatti
- Istituto Scientifico San Raffaele, Dipartimento di Chimica e Biochimica Medica, Milano, Italy
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