Mediterranean diet and epicardial adipose tissue in patients with atrial fibrillation treated with ablation: a substudy of the 'PREDIMAR' trial

AIMS

To analyse the relationship between Mediterranean diet (MedDiet) adherence and epicardial adipose tissue (EAT) in patients with atrial fibrillation (AF) and the association between EAT or MedDiet adherence at baseline with AF recurrence after ablation.

METHODS AND RESULTS

We included 199 patients from the PREDIMAR trial (PREvención con DIeta Mediterránea de Arritmias Recurrentes), in a single centre in this substudy. All of them had a computed tomography with EAT measurement. Lifestyle and clinical characteristics were obtained at baseline. The traditional MedDiet pattern was defined according to the MedDiet Adherence Screener (MEDAS). Any documented AF > 30 s after ablation was considered a recurrence. Multivariable-adjusted linear and logistic regression models were run to assess the cross-sectional association of MedDiet with EAT, and of EAT with the AF type at baseline. Also, Cox regression models were used to prospectively assess the associations of MedDiet adherence and EAT with AF recurrences after ablation. Median EAT was 135 g (interquartile range: 112-177), and the mean MedDiet score was 7.75 ± 2 points. A higher MEDAS ≥ 7 that was associated with lower odds of an EAT ≥ 135 g [multivariable odds ratio (mOR) = 0.45; 95% CI = 0.22-0.91; P = 0.025] was significantly associated with persistent AF after adjusting for traditional risk factors (mOR: 2.22; 95% CI: 1.03-4.79; P = 0.042). No significant associations were observed between EAT ≥ 135 g and the risk of atrial tachyarrhythmia recurrences after ablation [multivariable-adjusted hazard ratio (mHR) = 1.18; 95% CI: 0.72-1.94; P = 0.512], or between MEDAS ≥ 7 and AF recurrence (mHR = 0.78; 95% CI: 0.47-1.31; P = 0.344).

CONCLUSION

In patients with AF, higher adherence to MedDiet is associated with a significantly lower amount of EAT. Epicardial adipose tissue ≥ 135 g was significantly associated with persistent AF.

A Sexual Dimorphism in the Spatial Vision of North American Band-Winged Grasshoppers

Visual acuity (VA)-a measurement of the fineness or coarseness of vision-may vary within a species including between the biological sexes. Although numerous studies have found males with finer VA than females, relatively few have shown the opposite with females having finer vision. This is surprising because our understanding of between species differences in VA suggests that females may have finer vision than males if they 1) are larger than males, or 2) need finer vision to detect and/or discriminate between males. Here, we estimate the interommatidial angle (ΔΦ, an anatomical measurement of VA) in three species of band-winged grasshoppers in which females are both the larger sex and likely interpret visual signals (Arphia pseudonietana, Dissosteira carolina, and Spharagemon equale; total n = 98). Using a radius of curvature estimation method, we find that females have ∼19% finer estimated ΔΦ than males in the most acute region and axis of the eye, but that this dimorphism varies between species. Further visual explorations of the species showing the greatest body size dimorphism (D. carolina) suggest that this ΔΦ dimorphism is driven by females having larger eyes with more ommatidia. In contrast to many diurnal flying insects where males have finer vision to acquire mates, our study is one of the first to demonstrate a female-biased sexual dimorphism in acuity. Given 1) the number of species in which females are larger than males, and 2) the variability of mating behaviors across taxa, our results suggest that differences in VA between the sexes may be more common than currently appreciated. Resumen La agudeza visual (AV)-una medida de la finura o la dificultad visual-puede variar dentro de una especie, incluso entre los sexos biológicos. Aunque numerosos estudios han encontrado machos con una AV más fina que las hembras, relativamente pocos han demostrado lo contrario, hembras con visión más fina. Esto es sorprendente porque nuestra comprensión de diferencias entre especies en AV sugiere que las hembras pueden tener una visión más fina que los machos si 1) son más grandes que los machos, o 2) necesitan una visión más fina para detectar y/o discriminar entre los machos. Aquí, estimamos el ángulo interommatidial (ΔΦ, una medida anatómica de AV) en tres especies de saltamontes de ala de banda en las que las hembras son el sexo más grande y probablemente interpretan señales visuales (Arphia pseudonietana, Dissosteira carolina, y Spharagemon equale; total n = 98). Usando un método de estimación de radio de curvatura, encontramos que las hembras tienen un estimado ΔΦ ∼19% más fino que los machos en la región y eje más agudos del ojo, pero que este dimorfismo varía entre especies. Exploraciones visuales adicionales de la especie que muestra el mayor dimorfismo del tamaño corporal (D. carolina) sugieren que este dimorfismo de ΔΦ debe a que las hembras tienen ojos más grandes con más omatidios. En contraste con muchos insectos voladores diurnos donde los machos tienen una visión más fina para adquirir parejas, nuestro estudio es uno de los primeros en demostrar un dimorfismo sesgado por las hembras en la agudeza. Dado 1) el número de especies en las que las hembras son más grandes que los machos, y 2) la variabilidad de los comportamientos de apareamiento entre taxones, nuestros resultados sugieren que las diferencies de AV entre los sexos pueden ser más comunes de lo que se aprecia actualmente.

Nitric oxide modulation of coronary artery myogenic tone in spontaneously hypertensive and Wistar-Kyoto rats

1. The endothelium contributes substantially to the modulation of myogenic tone in coronary arteries from spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY). This study has addressed the contributions of endothelium-derived nitric oxide and cyclo-oxygenase products to this modulation in small coronary arteries (approximately 200 microns internal diameter) from 20-week-old SHR and WKY under pressurized, no-flow conditions in an arteriograph. 2. Active pressure-diameter relationships were uninfluenced by the cyclo-oxygenase inhibitor indomethacin (10 mumol/l) in either rat strain. In the presence of indomethacin and the nitric oxide synthase inhibitor N omega-nitro-L-arginine (L-NNA, 0.1 mmol/l), coronary arteries from SHR and WKY generated significantly greater myogenic tone. This increase in tone was similar in both strains. 3. In endothelium-denuded arteries, indomethacin and L-NNA did not influence tone. 4. Therefore, these results demonstrate that endothelium-derived nitric oxide is basally released to attenuate SHR and WKY coronary artery myogenic tone, whereas endothelium-derived cyclo-oxygenase products have no net vasoactive influence. Additionally, these data suggest that basal nitric oxide-mediated relaxation is normal in SHR coronary arteries and is therefore unlikely to be a pathogenic mechanism in this animal model of hypertension.

Myogenic tone in coronary arteries from spontaneously hypertensive rats

The aims of this study were to investigate myogenic tone in cannulated coronary arteries from SHR (spontaneously hypertensive rats) and WKY (Wistar-Kyoto rats) at 5 and 20 weeks of age under pressurised no-flow conditions. Pressure-diameter relationships (20-200 mm Hg) were determined in the presence (active) and absence (passive) of calcium and myogenic tone at each pressure was calculated. Active, but not passive diameter-pressure relationships were significantly different between strains at both ages. Active diameters were similar between strains at pressures up to 140 mm Hg at 5 and 20 weeks. At higher pressures SHR arteries generated more tone. Maximum myogenic tone was similar between strains in spite of increased wall thickness in the SHR at both ages. Endothelium denudation increased myogenic tone to a greater extent in the SHR at both ages. Active diameters of endothelium-denuded SHR arteries were smaller than those of WKY in the range 20-120 mm Hg at 5 week and 20-80 and 160-180 mm Hg at 20 weeks. These results demonstrate that during both the developmental and established phases of hypertension, myogenic tone is not enhanced in intact SHR coronary arteries, except at the highest pressures. Following endothelium removal SHR arteries generated greater myogenic tone also at lower pressures. These data demonstrate a greater endothelium-mediated antagonism of myogenic tone in SHR coronary arteries.