Hemostatic factors as predictors of coronary events and total mortality: The FINRISK '92 Hemostasis Study

The role of hemostatic factors as predictors of coronary heart disease (CHD) and total mortality is poorly understood. Therefore, we carried out a prospective cohort study in Finland. In 1992, a random population sample of 2378 men and women aged 45 to 64 years was investigated and then followed up until December 31, 1998. During the follow-up, 133 CHD events were observed; 73 were among participants free of CHD at baseline. The total number of deaths was 124. After adjustment for traditional risk factors and prevalent CHD at baseline and correction for regression dilution bias, a 1-SD increase in plasminogen was associated with a 1.41-fold (95% CI 1.09 to 1.81) increase in CHD risk. The predictive power of plasminogen depended significantly on the level of total cholesterol being stronger for persons with high cholesterol. A 1-SD increase in fibrinogen was associated with a 1.23-fold (95% CI 1.05 to 1.44) increase in all-cause mortality, but its association with CHD events did not reach statistical significance. Factor VII antigen or coagulant activity or lipoprotein(a) were not independent predictors of CHD risk. These findings support the role of plasminogen as a risk factor for CHD events.     

Evidence for fusion between cardiac and skeletal muscle cells

Cardiomyoplasty with skeletal myoblasts may benefit cardiac function after infarction. Recent reports indicate that adult stem cells can fuse with other cell types. Because myoblasts are "fusigenic" cells by nature, we hypothesized they might be particularly likely to fuse with cardiomyocytes. To test this, neonatal rat cardiomyocytes labeled with LacZ and green fluorescent protein (GFP) were cocultured with unlabeled C2C12 myoblasts. After 3 days, we observed a small population of skeletal myotubes that expressed LacZ and GFP, indicating cell fusion. To test whether such fusion occurred in vivo, LacZ-expressing C2C12 myoblasts were grafted into normal nude mouse hearts. At 2 weeks after grafting, cells at the graft-host interface expressed both LacZ and cardiac-specific myosin light chain 2v (MLC2v). To test more definitively whether fusion between skeletal and cardiac muscle could occur, we used a Cre/lox reporter system that activated LacZ only upon cell fusion. When neonatal cardiomyocytes from -myosin heavy chain promoter (-MHC)-Cre mice were cocultured with myoblasts from floxed-lacZ reporter mice, LacZ was activated in a subset of cells, indicating cell fusion occurred in vitro. Finally, we grafted the floxed-lacZ myoblasts into normal hearts of -MHC-Cre+ and -MHC-Cre- mice (n=5 each). Hearts analyzed at 4 days and 1 week after transplantation demonstrated activation of LacZ when the skeletal muscle cells were implanted into hearts of -MHC-Cre+ mice, but not after implantation into -MHC-Cre- mice. These data indicate that skeletal muscle cell grafting gives rise to a subpopulation of skeletal-cardiac hybrid cells with a currently unknown phenotype. The full text of this article is available online at http://circres.ahajournals.org.     

Search for an optimal therapy of patients with atrial fibrillation (results of many years of comparison of three treatment strategies).

Patients with nonrheumatic atrial fibrillation (n=465, mean age 59.4+/-3.8 years) received controlled therapy for 7.4+/-1.6 years. Group 1 comprised 306 patients with paroxysmal and persistent atrial fibrillation who after restoration of sinus rhythm received antiarrhythmic therapy aimed at prevention of recurrences and repetitive cardioversions. Group 2 consisted of 67 similar patients who did not receive continuous antiarrhythmic therapy. Therapy of patients with persistent atrial fibrillation (group 3, n=92) included heart rate slowing drugs and anticoagulants. Group 1 was characterized by lowest rate of complications and all cause mortality, and best quality of life. There were more nonfatal strokes in group 2. All cause mortality in group 2 was 15% (p<0.05). Highest rate of nonfatal strokes, and deaths due to chronic heart failure was observed in group 3. All cause mortality in this group was 22.8% (p<0.001 vs group 1).     

Atherosclerosis of abdominal aorta and carotid arteries and its correlation with blood serum lipid levels in cholelithiasis

AIM: To elucidate relationship between cholelithiasis and presence and severity of atherosclerosis in abdominal aorta and carotid arteries. MATERIAL AND METHODS: Ultrasound investigation of vessels and abdominal organs, determination of blood serum total, high density lipoprotein cholesterol and triglycerides were carried out in 147 patients with and 167 without (controls) cholelithiasis (mean age 44.2+/-3.1 and 45+/-2.8 years, respectively). RESULTS: Among patients with cholelithiasis 73.2 and 67.6% had atherosclerosis of abdominal aorta and carotid arteries, respectively. This was significantly more than in controls. Compared with controls atherosclerosis of these vessels in all age groups was significantly more pronounced in patients with cholelithiasis. Moreover severity of atherosclerosis was directly related to duration and activity of cholelithiasis. Atherosclerosis of abdominal aorta and carotids was most pronounced in patients with cholelithiasis and concomitant hypertension, ischemic heart disease and obesity. Significant direct correlations were found between blood serum levels of total cholesterol, triglycerides and low density lipoprotein cholesterol and thickness of abdominal aortic wall and carotid artery intima media complex. CONCLUSION: The results evidence for the existence of association between cholelithiasis and presence and severity of atherosclerosis of abdominal aorta and carotid arteries.     

Body composition changes by DXA, BIA and skinfolds during exercise training in women

Purpose

Few studies have examined responsiveness of bioimpedance (BIA) to detect changes over time in body composition using a longitudinal design. Accuracy of BIA and skinfold thickness in estimating body composition among 39–64 year-old women was investigated using dual-energy X-ray absorptiometry (DXA) as a criterion method both cross-sectionally and during a training intervention.

Methods

97 women had percentage of fat assessed using DXA, skinfolds and eight-polar BIA using multi-frequency current. Fat mass and lean mass were estimated by DXA and BIA. Measurements were performed before and after the 21-week training intervention.

Results

At baseline relative to DXA, BIA under predicted percentage of fat (?6.50 %) and fat mass (?3.42 kg) and overestimated lean mass (3.18 kg) considerably. Also skinfold measurement under predicted percentage of fat compared to DXA, but the difference was smaller (?1.69 % units). Skinfold measurement overestimated percentage of fat at low values and underestimated at high values (r ² = 0.535). A significant bias was detected between DXA and BIA’s estimate of change in percentage of fat, fat mass and lean mass. Compared to DXA, BIA and skinfolds underestimated the training-induced positive changes in body composition.

Conclusions

BIA and skinfold methods compared to DXA are not interchangeable to quantify the percentage of fat, fat mass and lean mass at the cross-sectional design in middle-aged women. Moreover, exercise training-induced small changes in body composition cannot be detected with BIA or skinfold method, even though DXA was able to measure statistically significant within-group changes in body composition after training.     

Aortic root dimensions as a correlate for aortic regurgitation’s severity

The International Journal of Cardiovascular Imaging - To evaluate the prevalence of aortic regurgitation (AR) and associations between the individual aortic root components and AR severity in the...