Cardiovascular Effects of Omeprazole and Famotidine

In a randomized, placebo-controlled, double-blind, crossover comparison, 12 patients with congestive heart failure (New York Heart Association class II) and dyspeptic complaints were treated orally for 1 week each with placebo, 40 mg omeprazole daily, and 40 mg famotidine daily. Non-invasive haemo-dynamic measurements were taken on the last day of treatment. Although omeprazole did not alter cardiac performance in impedance cardiography and mechanocardiography, the administration of famotidine led to a significant fall in stroke volume and cardiac output as compared with placebo (both p < 0.05). Thus, omeprazole did not exert any relevant cardiovascular effects, in contrast to the H₂-receptor antagonist famotidine.     

Cardiovascular Effects of Medical Marijuana: A Systematic Review

Utilization of marijuana as a medicinal agent is becoming increasingly popular, and so far, 25 states have legalized it for medical purposes. However, there is emerging evidence that marijuana use can result in cardiovascular side effects, such as rhythm abnormalities, syncope/dizziness, and myocardial infarction, among others. Further, there are currently no stringent national standards or approval processes, like Food and Drug Administration (FDA) evaluation, in place to assess medical marijuana products. This review includes the largest up-to-date pooled population of patients with exposure to marijuana and reported cardiovascular effects. Although purported as benign by many seeking to advance the use of marijuana as an adjunctive medical therapy across the country, marijuana is associated with its own set of cardiovascular risks and deserves further definitive study and the same level of scrutiny we apply in research of all other types of medications. When used as a medicinal agent, marijuana should be regarded accordingly, and both clinical providers and patients must be aware of potential adverse effects associated with its use for early recognition and management.     

合成代谢类固醇与心血管疾病（综述）

合成代谢类固醇（AAS)是一类在结构及活性上与人体雄性激素睾酮相似的化学合成衍生物，其具有合成雄性性激素类似的生理作用。因此AAS最早用于提高性功能，后也被滥用于体育运动员来促进肌肉生长和提高力量。然而，随着研究进展发现使用AAS会导致很多不良反应，尤其促进心血管疾病发生。为进一步认识AAS在心血管疾病中的作用，本文对这两者之间的关系做一综述。     

The effect of diabetes on the metabolism of mucopolysaccharides

Riassunto Il diabete determina profonde alterazioni del metabolismo dei mucopolisaccaridi solforati, alterazioni che divengono evidenti ancor prima che si manifesti l'iperglicemia. Dopo 4 h dall'iniezione di solfato marcato, l'incorporazione di³⁵S-solfato nei mucopolisaccaridi aortici di ratti diabetici appare aumentata; dopo tale periodo, la sintesi di composti solforati diminuisce. La concentrazione degli isomeri del condroitin-solfato nell'aorta aumenta nei ratti con diabete iniziale, diminuisce negli animali con diabete cronico. L'incorporazione di solfato marcato nel condroitin-solfato ad opera del sistema enzimatico presente nel fegato dei ratti diabetici è inibita da concentrazioni di enzima più elevate. Questa inibizione corrisponde ad una depressione nella formazione dell'intermedio trasportatore attivo di solfato, il fosfoadenosin-fosfosolfato, nel diabete. Tenendo conto di questi reperti e dei risultati ottenuti da altri ricercatori, viene proposta un'ipotesi relativa all'elevata incidenza, nel diabete, di malattie cardiovascolari.

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The effect of diabetes on the metabolism of mucopolysaccharides

Summary Diabetes produces a profound alteration in the metabolism of sulfate mucopolysaccharides which becomes evident even before the development of hyperglycemia.³⁵S-sulfate uptake into aortic mucopolysaccharides of diabetic rats is increased 4 hrs after injection of labeled sulfate, following which the synthesis of sulfated compounds is decreased. The concentration of aortic chondroitin sulfate isomers is increased in animals with early diabetes, whereas the concentration of these fractions is decreased in aortas of rats with chronic diabetes. The uptake of labeled sulfate into chondroitin sulfate by the hepatic enzyme system of diabetic rats is inhibited with higher concentrations of enzyme. This inhibition corresponds with a depression in the formation of the active sulfate carrier intermediate, phosphoadenosine-phosphosulfate, in diabetes. In view of these findings and results of other workers, a hypothesis is proposed concerning the high incidence of cardiovascular disease in diabetes.

Supported by Grants Nos. 3493/68 and 3493 a) 69 from the Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina. This work represents part of a dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at the University of Buenos Aires.     

High prevalence of cardiovascular and respiratory abnormalities in advanced,intensively treated (transplanted) myeloma: The case for ‘late effects’ screening and preventive strategies

Objectives: Modern management of myeloma has significantly improved survival, with increasing numbers of patients living beyond a decade. However, little is known about the long-term cardiovascular and respiratory status of intensively treated and multiply relapsed survivors.

Methods: We performed detailed cardiovascular and respiratory evaluations in patients with intensively treated, advanced but stable myeloma. All patients had received at least two lines of treatment, including at least one haematopoietic stem cell transplantation procedure, but had stable, controlled disease and were off active treatment at the time of evaluation.

Results: Thirty-two patients with a median duration of 6 years (range 2–12) from original diagnosis of myeloma and three lines (range 2–6) of treatment were evaluated. Despite normal physical examination in the majority, there was a high prevalence of sub-clinical cardiac and respiratory dysfunction, reflected by abnormalities of electrocardiography (45%), echocardiography (50%), serum N-terminal pro-B-type natriuretic peptide level (NT-pro-BNP, 50%), and pulmonary function testing (45%). NT-pro-BNP level correlated negatively with quality of life (P?=?0.012) and positively with serum ferritin (P?=?0.027). Dyspnoea score correlated with BMI (P?=?0.001). Risk factors for cardiovascular disease (obesity, hypertension, hyperlipidaemia, and hyperinsulinaemia) were common.

Discussion: Even in the absence of overt clinical features, the majority of intensively treated long-term survivors of myeloma have established cardiovascular and/or respiratory dysfunction, above levels expected in the general population of a similar age.

Conclusion: This study supports routine screening and lifestyle modification combined with primary and secondary preventive strategies to reduce cardiovascular and respiratory disease and to preserve quality of life in transplanted myeloma patients.     

Caffeine Reduces Myocardial Blood Flow During Exercise

Caffeine consumption has been receiving increased interest from both the medical and lay press, especially given the increased amounts now available in energy products. Acute ingestion of caffeine usually increases cardiac work; however, caffeine impairs the expected proportional increase in myocardial blood flow to match this increased work of the heart, most notably during exercise. This appears to be mainly due to caffeine's effect on blocking adenosine-induced vasodilatation in the coronary arteries in normal healthy subjects. This review summarizes the available medical literature specifically relating to pure caffeine tablet ingestion and reduced exercise coronary blood flow, and suggests possible mechanisms. Further studies are needed to evaluate this effect for other common caffeine-delivery systems, including coffee, energy beverages, and energy gels, which are often used for exercise performance enhancement, especially in teenagers and young athletes.     

A randomized 9-month study of blood pressure and body fat responses to aerobic training versus combined aerobic and resistance training in older men

This randomized study evaluated the impact of different exercise training modalities on blood pressure and body fat responses in apparently healthy older men. Forty-eight elderly men (aged 65–75 years) were randomly assigned to an aerobic training group (ATG, n = 15), a combined aerobic and resistance training group (CTG, n = 16), or a control group (n = 17). Both exercise training programs were moderate-to-vigorous intensity, three days/week for 9-months. Strength, aerobic endurance, body fat and blood pressure were measured on five different occasions. The data were analyzed using a mixed-model ANOVA, and the independence between systolic blood pressure (SBP), diastolic blood pressure (DBP) and group was tested. A significant main effect of group (p < 0.001) was observed in strength and aerobic endurance, with higher performance observed in the CTG. A significant main effect of group (p < 0.001) and time (p = 0.029) was observed in body fat percentage, with a 2.3% decrease in CTG. A significant main effect of time was observed in SBP (p = 0.005) and in DBP (p = 0.011) for both ATG and CTG. Mean decreases in SBP and DBP, respectively, were 15 and 6 mmHg for ATG and 24 and 12 mmHg for CTG. There was a significant association for SBP (p = 0.008) and DBP (p = 0.005) in the CTG, with significant individual BP profile modifications. Both exercise-training programs reduce resting blood pressure. However, only the combined exercise training was effective at reducing body fat percentage; consequently, there were larger changes in blood pressure, which result in a significant reduction in hypertensive subjects.     

Corticosteroid use and its association with microalbuminuria in the adult population

BACKGROUND: Corticosteroids exhibit a wide range of adverse effects, among which are a number of cardiovascular effects. Microalbuminuria shows a strong correlation with these cardiovascular effects and is an indicator for cardiovascular risk. We now investigate whether use of corticosteroids, either systemic or nonsystemic, is associated with microalbuminuria. METHODS: We used the data of 7010 subjects of an on-going population based study, focussed on the impact of microalbuminuria (PREVEND). Microalbuminuria was defined as urinary albumin excretion of 30-300 mg/24 h, measured as the mean of two 24-h urine collections. Corticosteroid use was measured in the year preceding the albumin measurement using community pharmacy data. RESULTS: After adjusting for age and sex, the odds ratio (OR) for having microalbuminuria was slightly elevated (1.21; 95% CI 1.03-1.41; N=1798) for corticosteroid users. The ORs were lower for subjects using only systemic corticosteroids (1.07; 95% CI 0.67-1.72; N=146), or only local corticosteroids (1.11; 95% CI 0.93-1.32; N=1442). However, the OR for subjects using both systemic and local corticosteroids was raised (1.99; 95% CI 1.42-2.77; N=210). CONCLUSION: Corticosteroid use, and especially use of both systemic and local corticosteroids is associated with microalbuminuria. Based on this investigation we cannot say if this is due to adverse effects of corticosteroids themselves, or effects of the underlying disease.     

Carvedilol: Molecular and Cellular Basis for Its Multifaceted Therapeutic Potential

Carvedilol is a unique cardiovascular drug of multifaceted therapeutic potential. Its major molecular targets recognized to date are membrane adrenoceptors (β₁,β₂, and α₁), reactive oxygen species, and ion channels (K⁺ and Ca²⁺). Carvedilol provides prominent hemodynamic benefits mainly through a balanced adrenoceptor blockade, which causes a reduction in cardiac work in association with peripheral vasodilation. This drug assures remarkable cardiovascular protection through its antiproliferative/atherogenic, antiischemic, antihypertrophic, and antiarrhythmic actions. These actions are a consequence of its potent antioxidant effects, amelioration of glucose/lipid metabolism, modulation of neurohumoral factors, and modulation of cardiac electrophysiologic properties. The usefulness of carvedilol in the treatment of hypertension, ischemic heart disease, and congestive heart failure is based on a combination of hemodynamic benefits and cardiovascular protection.     

Cardiovascular effects of antiretroviral therapy and noninvasive assessments of cardiovascular disease in HIV infection

The heart is frequently affected in patients with the acquired immune deficiency syndrome (AIDS). Although the introduction of potent antiretroviral therapy (ART) has produced a sharp decline in mortality and morbidity in HIV-infected patients, the use of ART is associated with the development of peripheral insulin resistance, dyslipidemia, and lipodystrophy. These abnormalities are also associated with coronary artery disease, and numerous reports of myocardial infarction in young HIV-infected patients have raised concerns of premature coronary disease in this population. A comprehensive review of the epidemiology of coronary artery disease is given. In recent years, several noninvasive methods to detect early development of atherosclerosis have been evaluated. Two noninvasive techniques using ultrasound have emerged as valid methods to detect early development of atherosclerosis: intima-media thickness and endothelial dysfunction assessed by the measurement of flow-mediated brachial artery dilatation. Multicenter, randomized trials using either technique may provide more information about whether HIV infection alone, long-term HAART use, or both may increase the risks of or accelerate coronary disease in HIV-infected patients.     

Celecoxib-related gastroduodenal ulcer and cardiovascular events in a randomized trial for gastric cancer prevention

AIM： To evaluate the long-term risk of gastroduodenal ulcer and cardiovascular events induced by celecoxib in a population-based, randomized, double-blind, placebo-controlled study.
METHODS： From 2004 to 2006, a total of 1024 Chinese patients （aged 35 to 64 years） with severe chronic atrophic gastritis, intestinal metaplasia or dysplasia were randomly assigned to receive 200 mg of celecoxib twice daily or placebo in Linqu County （Shandong Province, China）, a high-risk area of gastric cancer. All gastroduodenal ulcer and cardiovascular events occurred were recorded and the patients were followed up for 1.5 years after treatment. At the end of the trial, a systematic interview survey about other adverse events was conducted.
RESULTS： Gastroduodenal ulcer was detected in 19 of 463 （3.72%） patients who received celecoxib and 17 of 473 （3.31%） patients who received placebo, respectively （odds ratio = 1.13, 95% CI = 0.58-2.19）. Cardiovascular （CV） events occurred in 4 patients who received celecoxib and in 5 patients who received placebo, respectively. Compared with those who received placebo, patients who received celecoxib had no significant increase in occurrence of CV events （hazard ratio = 0.84, 95% CI = 0.23-3.15）. Among the adverse events acquired by interview survey, only the frequency of bloating was significantly higher in patients treated with celecoxib than in those treated with placebo.
CONCLUSION： Treatment of gastric cancer with celecoxib is not associated with increased risk of gastroduodenal ulcer and cardiovascular events.     

Cardiovascular Characterization of DA-1 and DA-2 Dopamine Receptor Agonists in Anesthetized Rats

This report summarizes studies aimed to characterize pharmacologically, hemodynamically and biochemically DA-1 (fenoldopam) and DA-2 (quinpirole) dopamine receptor agonists in anesthetized rats. Fenoldopam (20 μg/kg/min i.v. over 15 min) and quinpirole (10 μg/kg/min i.v. over 15 min) share the common property of decreasing mean carotid artery blood pressure by lowering peripheral vascular resistance. Fenoldopam increased mesenteric and renal blood flows whereas quinpirole decreased the former blood flow, but enhanced the latter. These effects of quinpirole were antagonized selectively by S-sulpiride, but not SCH 23390; however, with fenoldopam the reverse was found. In chlorisondamine-pretreated rats with blood pressure supported by vasopressin, fenoldopam, but not quinpirole, caused hypotension. In nephrectomized rats, the blood pressure effects of fenoldopam (assessed as area under the infusion time-response curve) were more pronounced than in sham-operated controls. The hypotensive effects due to an i.v. bolus injection of fenoldopam, but not to acetylcholine, histamine, salbutamol or quinpirole, were significantly inhibited in rats pretreated with an infusion of fenoldopam. In pithed rats, quinpirole reduced the pressor responses to electrical stimulation of the spinal cord without affecting those to exogenous norepinephrine, angiotensin 11 or 5-hydroxytryptamine which, on the contrary, were inhibited by fenoldopam. The plasma renin activity (in intact rats) was reduced by quinpirole, but elevated by fenoldopam. The latter effect also occurred in pithed rats and was blocked by SCH 23390. Quinpirole lowered heart rate, whilst fenoldopam produced tachycardia. These effects of quinpirole and fenoldopam were significantly inhibited by S-sulpiride and SCH 23390, respectively. In chlorisondamine-pretreated rats quinpirole failed to change heart rate     

Electronic cigarettes——myocardial infarction,hemodynamic compromise during pregnancy,and systolic and diastolic dysfunction: Minireview

The aim of this study was to review the most recent literature on the safety of electronic cigarettes(ECs) in the context of cardiovascular disease and in the context as a tool for smoking cessation and recreational purposes. The format of this review begins with relevant research from the basic sciences and follows through with a pertinent review of clinical trials. Daily use of ECs has implications in myocardial infarction(MI) with an odds ratio of 1.70 compared to healthy, nonsmokers and even worse risk for MI with dual use of combustible cigarettes together with EC with an odds ratio of 4.62. Studies measuring cardiac function with echocardiography reported both systolic and diastolic dysfunction along with reduced ejection fractions. Platelet aggregation, endothelial function, and hemodynamics during pregnancy were all but some of the pernicious cardiovascular implications of EC exposure. Though more studies need to be done on the topic of EC use and cardiovascular disease, the majority of studies considered in this review concluded some level of harm albeit in some instances less than that of traditional combustible cigarettes. ECs are toxic to human beings and their harmful effects cannot be overlooked. There is some favorable evidence of efficacy in smoking cessation though mixed with concern of chronic EC use. It will take decades to collect data for chronic EC use on long term sequelae, such as lung cancer. Though more and more reports of acute lung injury and hospitalizations related to EC use have been reported. Due to undergoing investigations of possible harm and life threatening complications of EC use, we cannot recommend ECs as safer or a more efficacious method of smoking cessation to traditional nicotine replacement therapies. A notable consideration for much of the literature reviewed are that standardization of EC use is difficult as device generation and battery voltage, frequency of use, and contents of ECliquid are just some of the vast complicating factors that limit the ability to effectively compare data.     

长链非编码RNA与心血管发育及疾病的关系

长链非编码RNA(long non-coding RNA,lncRNA)是一类转录本长度超过200nt功能性RNA分子。研究表明lncRNA参与调控机体的生长发育、细胞凋亡、增殖、分化等,与多种疾病密切相关。目前lncRNA的功能和作用机制尚不清楚,已有一些研究证实lncRNAs是参与心血管疾病发生发展的重要调控分子。现将lncRNA对心脏的发育及与心血管疾病的作用机制研究进展作一综述。     

血液透析患者心血管标志物水平变化与其预后的相关性研究

<正>各种慢性肾病若不能有效治疗,最终都会发展为终末肾病(end stage renal disease,ESRD)。目前,对于ESRD最普遍可行的治疗手段主要是血液透析(maintain hemodialysis,MHD)~[1,2]。研究发现ESRD和心血管疾病(cardiovascular disease,CVD)的发生密切相关,且CVD是MHD患者的主要死亡原因,有研究表明肌钙蛋白(TnT)、氨基末端脑钠肽前体(Nterminal pro-B-type natriuretic peptide,NT-pro BNP)检     

Effects of exercise training on diastolic and systolic dysfunction in patients with chronic heart failure

BACKGROUNDChronic heart failure (CHF) is a complex syndrome characterized by a progressive reduction of the left ventricular (LV) contractility, low exercise tolerance, and increased mortality and morbidity. Diastolic dysfunction (DD) of the LV, is a keystone in the pathophysiology of CHF and plays a major role in the progression of most cardiac diseases. Also, it is well estimated that exercise training induces several beneficial effects on patients with CHF. AIMTo evaluate the impact of a cardiac rehabilitation program on the DD and LV ejection fraction (EF) in patients with CHF.METHODSThirty-two stable patients with CHF (age: 56 ± 10 years, EF: 32% ± 8%, 88% men) participated in an exercise rehabilitation program. They were randomly assigned to aerobic exercise (AER) or combined aerobic and strength training (COM), based on age and peak oxygen uptake, as stratified randomization criteria. Before and after the program, they underwent a symptom-limited maximal cardiopulmonary exercise testing (CPET) and serial echocardiography evaluation to evaluate peak oxygen uptake (VO_2peak), peak workload (W_peak), DD grade, right ventricular systolic pressure (RVSP), and EF.RESULTSThe whole cohort improved VO_2peak, and W_peak, as well as DD grade (P < 0.05). Overall, 9 patients (28.1%) improved DD grade, while 23 (71.9%) remained at the same DD grade; this was a significant difference, considering DD grade at baseline (P < 0.05). In addition, the whole cohort improved RVSP and EF (P < 0.05). Not any between-group differences were observed in the variables assessed (P > 0.05).CONCLUSIONExercise rehabilitation improves indices of diastolic and systolic dysfunction. Exercise protocol was not observed to affect outcomes. These results need to be further investigated in larger samples.