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1.
Zouaoui W Ouldzein H Drissa MA Essafi N Meddeb I Drissa H 《Annales de cardiologie et d'angeiologie》2009,58(2):86-93
Objectives
To study the early and late results of mitral valve replacement (MVR) by Starr-Edwards caged-ball and bileaflet mechanical prosthesis.Material and methods
We retrospectively analyzed 236 MVR performed in 236 patients: 127 by Starr-Edwards prosthesis (group 1) and 109 by bileaflet prosthesis (group 2).Results
During the early period (30 days), the mortality rate was higher in group 1 (6.3 % vs 1.8 %; p = 0.0001), while hemorrhagic, thromboembolic and infectious complications were comparable in the two groups. In the late period (> 30 days) and with an average follow-up of 11.5 ± 5.7 years, mortality was higher in group 1 (9.4 % vs 4.6 %; p < 0.0001). The same was true for thromboembolic complications (20.8 % vs 6.4 %; p < 0.0001), hemorrhagic complications (13.4 % vs 7.3 %; p = 0.02), infectious complications (3.1 % vs 0.9 %; p = 0.02) and cardiac complications that were not due to the prosthesis (32.3 % vs 14.7 %; p = 0.02). The hemodynamic profile of the bileaflet prostheses was better than that of the Starr-Edwards prostheses (average functional prosthetic surface area was 2.37 ± 0.44 cm2 and average pressure gradient was 5.6 ± 1.1 mmHg vs 2.04 ± 0.52 cm2 and 7.6 ± 4.9 mmHg).Conclusion
Our work confirms the superiority of bileaflet mechanical prostheses, with rates of early and late mortality, thromboembolic and hemorrhagic complications lower than those of the Starr-Edwards prostheses in more than 11 years of follow-up. However, one should not forget that the prevention of infective endocarditis, good observance of oral anticoagulant treatment and early surgery before left ventricular dysfunction occurs remain the best guarantee a good result of the MVR. 相似文献2.
P. Abassade F. Rabenirina P. Garcon Y. Antakly R. Cador 《Annales de cardiologie et d'angeiologie》2009,58(5):289-292
Anemia is a common disorder in congestive heart failure and an independant prognostic factor. The aims of this study are to evaluate the prevalence of anemia among a population of in-hospital congestive heart failure patients, to compare anemic patients (A) with non anemic patients (NA) and to study their cares.
Results
One hundred and thirty-two patients, 70 men (53%), et 62 women (47%) are enrolled. Mean age is 76.4 ± 13.5 years. The prevalence of anemia (WHO criteria) is 49%. Patients A are older than NA: 79.1 ± 13.8 years versus 73.8 ± 12.9 years (p = 0.025), renal function is more altered in A than in NA, creatinine clearance is 56.5 ml/min (A) versus 76.2 ml/min (NA) (p = 0.003). Ejection fraction (EF) is lower in A than in NA: 35.1 ± 15.3% versus 50.9 ± 15.9%, (p < 0.0001.) Anemia is less frequent in preserved EF (28%) than in low EF (63%) (p < 0.0001). Hospitalization duration is longer in A than in NA: 10.7 ± 10.1 days versus 6.9 ± 3.7 days (p = 0.005). There are more re hospitalized patients among A than NA: 38 versus 10 (p = 0.0001). There is a significant difference of survival of NA versus A at day 614 (p = 0.03).Conclusion
Anemia is frequent in our population, and is associated with others prognostic factors and comorbidity. 相似文献3.
M. Nakhjavani H. Karimi-Jafari O. Khalilzadeh A. Ghadiri-Anari 《Annales d'endocrinologie》2010,71(4):303-308
Objectives
It has been shown that insulin resistance is associated with a state of chronic low-grade inflammation. Furthermore, depletion of nitric oxide (NO) or ineffectiveness of NO-mediated vasodilator mechanisms are associated with arterial stiffness and progression of insulin resistance to type-2 diabetes. In this study, we decided to evaluate the association between asymmetric dimethylarginine ([ADMA], an endogenous NO synthase inhibitor), high-sensitivity C-reactive protein ([hs-CRP]; a marker of chronic inflammation) and insulin resistance in early-stage type-2 diabetes.Methods
A total of 40 diabetic patients and 40 age-, sex- and body mass index (BMI)-matched healthy adult volunteers were recruited in this case-control study. Diabetic patients were recently diagnosed and did not have a history of any diabetes-related complications. Fasting blood samples were obtained and fasting plasma glucose, cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, creatinine, insulin, ADMA and hs-CRP were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) was also calculated.Results
ADMA (0.9 ± 0.2 vs 0.7 ± 0.2 μmol/L; p < 0.001) and hs-CRP (3.0 ± 2.1 vs 1.3 ± 1.0 mg/L; p < 0.001) were significantly higher in diabetic participants vs healthy controls. Age- and sex-adjusted ADMA values were significantly (p < 0.05) correlated with hs-CRP (r = 0.279) and HOMA-IR (r = 0.288) in diabetic patients. These associations were not significant in healthy controls. The association between ADMA and HOMA-IR in diabetic patients remained significant (r = 0.255; p < 0.05), after adjustment for BMI, waist circumference, serum lipids, and hs-CRP. In multivariate regression analysis, ADMA and hs-CRP were independently correlated with diabetes.Conclusion
In early-stage type-2 diabetic patients, ADMA is an independent predictor of insulin resistance. Our results could possibly point to an independent mechanism for contribution of ADMA in development of insulin resistance. 相似文献4.
M. Lopez-Sublet S. Le JeuneB. Giroux-Leprieur D. AgnolettiR. Dhote J.J. Mourad 《Annales de cardiologie et d'angeiologie》2014
Aims
Sleep disorders like obstructive sleep apnea in adults are associated with increased sympathetic activity, which induced high blood pressure and could be associated with resistant hypertension. Some studies have demonstrated that high urinary catecholamine levels in obstructive sleep apnea patients may be decreased with continuous positive airway pressure therapy. However, very few studies have demonstrated a correlation between apnea-hypopnea index and urinary catecholamine levels in hypertension patients.Methods
In this pilot study, 20 hypertensive patients referred for hypertension work-up including night-time polygraphy and 24 h urinary catecholamine dosage were included.Results
Mean age was 51 ± 11 years (30–76), 68% were males. Diagnosis of obstructive sleep apnea was confirmed in 13 patients at the end of the work-up. Mean apnea-hypopnea index was 14 ± 9 (2–32). The only urinary catecholamine parameter significantly increased in patients with obstructive sleep apnea was 24 h urinary normetanephrine (1931 ± 1285 vs 869 ± 293 nmol/24 h; P < 0.05). However, this difference was not significant when this parameter was adjusted to 24 h urinary creatinine. We observed a significant positive correlation between AHI and 24 h urinary normetanephine (r = 0.486; P = 0.035).Conclusion
This pilot study confirms an isolated elevation of 24 h urinary normetanephrine in hypertensive patients with obstructive sleep apnea and shows a significant correlation between sleep disorders expressed by apnea-hypopnea index and urinary catecholamines excretion. 相似文献5.
H. Ghozzi M. Kassis Z. Sahnoun R. Abbes S. Hammami K. Zeghal 《Annales de cardiologie et d'angeiologie》2010,59(3):131-137
The aim of the study
Medication noncompliance is one of the daily problems of the physician. Improving the medication adherence allows better management of hypertension. The aim of this work was to determine the level of compliance for patients with hypertension and to identify factors that determine compliance.Methods
A cross-sectional study was carried out among a sample of hypertensive patients attending general and specialist practitioners in public or private clinics of Sfax. Two hundred and seventy-three participants had accepted to be interviewed. Patients were identified as noncompliants using a questionnaire developed by the Comité de lutte contre l’hypertension artérielle (CFLHTA).Results
Non-compliance rate was 63.4%. The low level of education was associated with a lower adherence. The monotherapy, the once-daily regimen with fewer number of tablets were associated with a better adherence (p < 10−6). The welcome and the availability of drugs in the public clinic affect positively the adherence of patients (p < 0.0002). A patient very satisfied with his consultation and the explanation given by the doctor about his illness and its treatment had a better adherence (p < 0.00003).Conclusion
Our study had demonstrated a low compliance with antihypertensive drug therapy. Tunisian health care system should elaborate a management plan which takes into account our particular predictors of compliance to improve adherence to antihypertensive medication. 相似文献6.
S. Ouali S. Abroug S. Taamalah A. Ben Khalfallah E. Boughzela 《Annales de cardiologie et d'angeiologie》2010,59(1):14-19
Purpose
Contrasting data exist about the hemodialysis induced changes of ventricular diastolic and systolic functions in adults. Few data in children with end-stage renal disease (ESRD) are reported. The aim of the present study was to evaluate the effect of a single hemodialysis (HD) session on left ventricular (LV) systolic and diastolic function using conventional pulsed-Doppler echocardiography and pulsed tissue Doppler imaging (TDI) in hemodialysis children.Methods
Thirty-five children with chronic renal failure (15 males, aged 12.8 ± 3.8 years) on maintenance hemodialysis underwent conventional 2D and Doppler Echo together with measurement of longitudinal mitral annular motion velocities. Echocardiographic parameters were obtained 30 minutes before and 30 minutes after HD. Paired data were compared.Results
Hemodialysis led to reduction in LV end-diastolic volume (p = 0.001), end-systolic volume (p = 0.05), left atrium area (p < 0.0001), peak early (E wave) transmitral flow velocity (p = 0.005), peak S velocity of pulmonary vein flow (p = 0.002), aortic time velocity integral (p < 0.0001) and aortic ejection time (p < 0.0001). No significant change in Tei Index was observed after HD. Regarding TDI measures, velocities were not affected by preload reduction. Only the early diastolic velocities on the septal side of the mitral annulus decreased significantly (p = 0.001) and the systolic velocities on the lateral side of the mitral annulus increased significantly (p = 0.042) after hemodialysis.Conclusions
Most of Doppler-derived indices of diastolic function are preload-dependant. TDI velocities and Tei Index were not or minimally affected by preload reduction in hemodialysis children. 相似文献7.
P. Urios I. Kassab A.M. Grigorova-Borsos R. Guillot P. Jacolot F. Tessier J. Peyroux M. Sternberg 《Diabetes research and clinical practice》2014
Aim
Advanced glycation endproducts (AGEs) have been shown to contribute to alteration of glomerular permselectivity to proteins in diabetes. Oxidative stress is required for AGE formation. Therefore we studied the effect of an antioxidant micronized purified flavonoid fraction (MPFF, DaflonR 500 mg), on urinary albumin clearance in diabetic rats.Methods
Hyperglycaemia was induced by streptozotocin 55 mg/kg IM at days 0 and 7 in normotensive Wistar rats (NWR, diabetes duration 5 months) or hypertensive Wistar Kyoto rats (SHR, diabetes duration 2 months). MPFF was administered at 300 mg/kg/day, from day −2 until sacrifice.Results
After 5 months of diabetes in NWR, MPFF reduced albumin clearance from 729 ± 92 to 392 ± 60 nl/min/kg, p < 0.01, and restored albuminemia from 20.4 ± 0.9 to 24.0 ± 1 g/l, p < 0.05; albumin fractional clearance was significantly diminished in the flavonoid-treated diabetic rats (0.360 ± 0.037‰ versus 1.335 ± 0.430‰ in the diabetic controls, p < 0.001); MPFF did not significantly modify blood glucose and plasma fructosamine levels. After 2 months of diabetes in SHR, MPFF reduced albumin clearance from 243 ± 121 to 101 ± 47 nl/min/kg, p < 0.05, and restored albuminemia from 21.1 ± 1.6 to 26.7 ± 2.2 g/l (p < 0.05); MPFF also decreased plasma fluorescence characteristic of AGEs (p < 0.02). Besides hesperetin, a main metabolite of MPFF recovered in plasma, inhibited in vitro the formation of the crosslinking AGE pentosidine in collagen incubated with high glucose (p < 0.001).Conclusion
Our results confirm the role of glycoxidative stress in diabetic nephropathy. MPFF might be useful as complementary treatment for preventing diabetic microangiopathy. 相似文献8.
Å. Beraki A. Magnuson S. Särnblad J. Åman U. Samuelsson 《Diabetes research and clinical practice》2014
Aims
To evaluate the associations between physical activity (PA) and metabolic control, measured by glycated hemoglobin (HbA1c), in a large group of children and adolescents with type 1 diabetes.Methods
Cross-sectional analysis of data from 4655 patients, comparing HbA1c values with levels of physical activity. The data for the children and adolescents were obtained from the Swedish pediatric diabetes quality registry, SWEDIABKIDS. The patients were 7–18 years of age, had type 1 diabetes and were not in remission. Patients were grouped into five groups by frequency of PA.Results
Mean HbA1c level was higher in the least physically active groups (PA0: 8.8% ± 1.5 (72 ± 16 mmol/mol)) than in the most physically active groups (PA4: 7.7% ± 1.0 (60 ± 11 mmol/mol)) (p < 0.001). An inverse dose–response association was found between PA and HbA1c (β: −0.30, 95% CI: −0.34 to −0.26, p < 0.001). This association was found in both sexes and all age groups, apart from girls aged 7–10 years. Multiple regression analysis revealed that the relationship remained significant (β: −0.21, 95% CI: −0.25 to −0.18, p < 0.001) when adjusted for possible confounding factors.Conclusions
Physical activity seems to influence HbA1c levels in children and adolescents with type 1 diabetes. In clinical practice these patients should be recommended daily physical activity as a part of their treatment. 相似文献9.
P.-H. Ducluzeau A. Benetos J. Covillard F. Geneix-Benabdallah P.-L. Prost 《Annales de cardiologie et d'angeiologie》2009,58(2):67-73
Objective
The aim of the Eclat survey was to evaluate the frequency of frailty in uncontrolled hypertensives and to individualize different frailty profiles.Patients and methods
This was an observational, prospective, longitudinal survey conducted in the cohort of uncontrolled hypertensive patients aged 55 years or more. Morbid events having occurred between two visits at a 6-month interval were reported. Patients with at least one event were considered to be frail. Predictive factors of at least one event were identified (logistic regression). The analysis was completed by a typological analysis (principal components analysis and clustering).Results
At least one event occurred in 211 (9%) of 2306 patients (males 55%, 67 ± 9 years old, blood pressure [BP] = 160 ± 11/93 ± 8 mmHg, diabetes 23%): cardiovascular (1.7%), gerontological (5.5%), onset of diabetes (1.3%), worsening of renal impact (2%). Three frailty profiles were identified: patients at low risk (n = 1507, event rate = 6%), with neither cardiovascular risk factors nor target organ damage; patients at moderate risk (n = 335, event rate = 12%) with numerous risk factors but no target organ damage and patients at high risk (n = 243, event rate = 23%), the older ones, in bad general condition, with target organ damage, sensorial deficits and cognitive disorders. In a population of uncontrolled hypertensives aged 55 years or more, 9% could be considered as frailty.Conclusion
Therapeutic measures might be adapted according to the frailty profile of the patient. With respect to treatment management, healthcare behaviour could differ depending on these frailty profiles. 相似文献10.
Karila L Seringe E Rouprêt M Peltier M Doulaki M Goumont M Loyez C Lefèvre JH 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2011,32(7):400-405
Purpose
The objective of this study was to analyze, during a transversal study, the predictive sociodemographic and individual factors to be ranked within the first 500 medical students in the 2009 French national ranking exam (NRE).Methods
In September 2009, 5570 medical students have chosen their subspecialty. They were invited to fill-up a questionnaire that included sociodemographics and educational items. Logistic regression was used to identify factors that were associated with being ranked within the first 500 medical students.Results
A total of 4712 students (two third of women) responded to the questionnaire (92.3% response rate). The mean age of respondents was 24.7 years (±1.79). In the multivariate analysis, independent factors associated with being ranked within the first 500 medical students at the NRE were: being less than 25-year-old (odds ratio [OR]: 1.8; 95%CI: 1.3-2.5; P < 0.001), region of origin (Île de France) (OR: 3.7; 95%CI: 2.3-5.8; P < 0.0001), to succeed at the first medical year examination for the first time (OR: 1.7; 95%CI: 1.2-2.4; P < 0.001), being in the first 20% of the medical students during externship (P < 0.0001), critical reading test (CRT) teaching by graduate doctors (OR: 1.5; 95%CI: 1.05-2.1; P < 0.001), and to participate in a national practicing ranking exam with a CRT (OR: 1.96; 95%CI: 1.3-3.03; P = 0.002).Conclusion
Our study identified six factors independently associated with being ranked within the first 500 medical students in the French NRE. Education and training of the CRT, newly introduced test in 2009, seem to play an important role. 相似文献11.
Tankova T Chakarova N Atanassova I Dakovska L 《Diabetes research and clinical practice》2011,92(1):46-52
Aim
To evaluate the performance of FINDRISC as a screening tool for prediabetes - impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) and undetected diabetes (UDD) in subjects at risk of developing diabetes.Subjects and methods
2169 subjects with at least one risk factor for diabetes completed the FINDRISC questionnaire and underwent an oral glucose tolerance test. FINDRISC performance was assessed using the area under the receiver operating characteristic curve (AUC-ROC).Results
56.6% of subjects demonstrated normal glucose tolerance (NGT), 14.5% - IFG, 11.4% - IGT and 17.5% - UDD. NGT group demonstrated mean FINDRISC 10.1 ± 3.4, IFG group - 13.8 ± 4.3 (p < 0.0001 vs. NGT), IGT group - 14.4 ± 5.4 (p < 0.0001 vs. NGT) and UDD group - 15.5 ± 4.8 (p < 0.0001 vs. NGT and IFG, p < 0.01 vs. IGT). The AUC-ROC was 0.70 (95% CI 0.67-0.73) for UDD and 0.71 (95% CI 0.69-0.73) for undetected prediabetes and diabetes. The FINDRISC cut-off value of 10 to identify both prediabetes and diabetes had sensitivity of 84% and specificity of 61%.Conclusions
FINDRISC is a feasible, non-invasive and useful tool for identifying subjects at risk for undetected diabetes and prediabetes. Laboratory screening should be performed in subjects with FINDRISC higher than 10. 相似文献12.
Salameh E Mallat S Hamdan R Azar H Azar R Kadri Z Kassab R Abou Jaude S Badaoui G 《Annales de cardiologie et d'angeiologie》2009,58(1):7-10
Background and aim
Decrease in heart rate variability (HRV) is a known risk factor for cardiovascular morbidity and mortality. The aim of our study is to evaluate HRV in chronic hemodialysis patients and to determine factors that might decrease or increase it.Methods
This is a retrospective study including 51 patients, 23 males and 28 females, with a mean of age of 64.5 years (23-84 years) on chronic hemodialysis for end stage renal disease due to various causes. Twenty-four-hour heart rate monitoring was recorded in all patients to evaluate HRV. HRV of hemodialysis patients was compared to normal patients (control). We also looked for correlation between HRV and a number of clinical and biological factors.Results
All HRV parameters were decreased in chronic hemodialysis patients compared to normal controls with a significant difference (p < 0.0005). HRV decreases with age (p = 0.012), and is lower in diabetic patients (p = 0.026). Interestingly, we found that chronic hemodialysis patients on beta-blockers had higher HRV with p = 0.011.Conclusion
HRV is reduced in chronic hemodialysis patients mainly in old and diabetic patients, but this decrease is less important in those receiving beta-blockers. 相似文献13.
Objectives
Although it is known that circulating levels of insulin-like growth factor-1 (IGF-1) are influenced by both physical exercise and dietary intake separately, there is little information regarding the additive effect of diets and training on IGF-1 regulation. To test this, we examined the combined effect of 30 days of two different diets (high-protein and high-carbohydrate) and exercise training on total IGF-1.Materials and methods
The study was carried out with four groups of rats; the sedentary group with standard diet (SS) (control group), standard diet with exercise (SE), high-protein diet with exercise (PE) and high-carbohydrate diet with exercise (CE). Serum IGF-1, insulin, corticosterone were analyzed.Results
IGF-1 concentrations were decreased by exercise training (p < 0.001) and only with protein diet (p < 0.05). Physical training, with and without diet, decreased body weight and food intake (p < 0.01) and increased corticosterone levels (p < 0.05). Carbohydrate diet did not cause major hormonal and metabolic alterations.Conclusion
The main result of this study was the decreased levels of IGF-1 in spite of high-protein diet, which is known to enhance IGF-1 secretion, and the little changes with carbohydrate diet. This may be related to the negative energy balance as a result of the catabolic state induced by exercise training and decreased calorie intake in protein diet. Thus, it can be concluded that the caloric restriction, regardless of dietary composition, decreased IGF-1 secretion. 相似文献14.
Sarica HL Anastasiou H Charitopoulou MR Karamaliki M Grapsa E 《Diabetes research and clinical practice》2011,94(2):249-254
Aim of the study
To determine whether there is pathogenetic link between red cells sodium-lithium counter-transport activity and digoxin-like immunoreactive substances (DLIS) in plasma of insulin-dependent diabetic (IDDM) and non-diabetic women with preexisting preeclampsia (PE).Subjects and methods
We studied Na+/Li+ CT activity in red cells and plasma levels of DLIS in 11 IDDM women with preexisting PE (Group 1), 13 IDDM without preexisting PE (Group 2) 23 non-diabetic women with preexisting PE (Group 3) and 12 non-diabetic women with normal pregnancy (Group 4) at least 4 months after delivery.Results
Na+/Li+ CT activity was higher in Group 1 compared to Group 2 (mean ± SEM 0.316 ± 0.05 vs 0.190 ± 0.02 mmol/LRBC/hr p < 0.05) and in Group 3 compared to Group 4 (0.365 ± 0.004 vs 0.168 ± 0.01 mmol/LRBC/hr, p < 0.01). Plasma levels of DLIS were higher in Group 3 compared to Group 4 (0.727 ± 0.189 vs 0.295 ± 0.066 ng/ml; p < 0.05); there was no statistically significant difference between the two diabetic groups. In Groups 1 and 3, Na+/Li+ CT activity was correlated to the plasma levels of DLIS (r = 0.927; p < 0.001 and r = 0.485; p < 0.05 respectively).Conclusion
Increased Na+/Li+ CT activity and increased plasma levels of DLIS may contribute to PE in IDDM and non-diabetic women. 相似文献15.
Background
The aim of this study was to assess resistance artery function in short-term chronic cigarette smokers and non-smoking control subjects.Methods
Reactive hyperemia was assessed in 19 cigarette smokers (age 23 ± 1 years) and 19 non-smokers (age 23 ± 1 years).Results
Cigarette smokers demonstrated a 23% lower peak forearm blood flow response compared with non-smokers (15.81 ± 0.66 vs. 20.58 ± 1.26 mL/min/100 mL, p < 0.05) and a 22% lower area under the curve of the reactive hyperemia response (607 ± 51.57 vs. 775 ± 53.51 mL/min/100 mL × 3 min, p < 0.05).Conclusions
These results indicate that smoking-induced impairments of vascular function occur early after the initiation of chronic cigarette smoking. 相似文献16.
S. Arques B. Pieri G. Biegle E. Roux R. Gelisse B. Jauffret 《Annales de cardiologie et d'angeiologie》2009,58(5):279-283
Objective
To address the clinical relevance of serum albumin and B-type natriuretic peptide (BNP) concentration in the prediction of in-hospital death in elderly patients with acute severe heart failure.Patients and methods
Seventy-four consecutive patients >70 years of age admitted for acute heart failure in NYHA class IV were prospectively included. BNP concentration was measured on admission and serum albumin concentration after clinical stabilization.Results
Mean age was 86.6 ± 5.7 years. Sixty-five percent of patients had a normal left ventricular ejection fraction. Eighteen patients died during the in-hospital stay. Those patients who died were older, had higher blood urea nitrogen and BNP concentration, had lower systolic blood pressure and serum albumin concentration than patients who survived. Heart rate, rhythm, left ventricular ejection fraction, serum creatinine and hemoglobin did not differ according to outcome. By multivariate analysis, albumin (p = 0.0017), BNP (p = 0.016) and age (p = 0.03) were independent predictors of in-hospital death. Serum troponin I measured on admission in 71 patients was predictive of in-hospital death (p = 0.01), as well as serum total cholesterol measured after stabilization in 66 patients (p = 0.004). However, these two variables no longer predicted outcome in multivariate models, unlike serum albumin and BNP.Conclusion
Serum albumin and BNP offer independent, additional information for the prediction of in-hospital death in elderly patient with acute severe heart failure regardless of left ventricular ejection fraction. 相似文献17.
Yasemin Ersoy Nihayet Mehmet Bayraktar Ibrahim Halil Ozerol Murat Aladag 《Hepatology research》2006,34(2):111-116
Background and aim
The aim of this study was to estimate the serum levels of endothelin-1 (ET-1) and nitric oxide (NO) and to analyze the correlation of their levels with histopathological grading and staging of the liver in patients with chronic hepatitis B (CHB) and C (CHC).Methods
Eighty-nine patients who were either HBsAg positive (45 CHB patients, 34 inactive carriers (IC)) or had CHC (10 patients) and 36 healthy volunteers as a control group were included in this study. Fifty patients from the CHB (n = 43) or CHC (n = 7) groups with elevated serum alanine transaminase (ALT) levels underwent a liver biopsy. Histological activity was scored according to Ishak's activity and the fibrotic index. The ET-1 serum concentration was determined with a commercially available ELISA assay kit. Total nitrite was measured by the Griess reaction as an index for NO production.Results
Serum levels of ET-1 and NO were significantly increased in CHB patients (7.67 ± 4.00 pg/ml and 172.44 ± 50.30 μmol/l, respectively) compared with the IC group (3.99 ± 5.42 pg/ml and 114.68 ± 32.22 μmol/l, respectively) and the control group (3.05 ± 0.65 pg/ml and 58.61 ± 24.18 μmol/l, respectively) (p < 0.0001). The CHC patients also had significantly higher serum levels of ET-1 (5.92 ± 4.24 pg/ml) and NO (147.50 ± 55.84 μmol/l) compared to the control group (p < 0.0001 and <0.001, respectively). Linear regression analysis identified that the level of ET-1 was an independent variable that correlated significantly with the stage score (r2 = 0.348, p < 0.0001) in CHB patients but there was no correlation in the CHC group.Conclusion
ET-1 and NO levels were increased in chronic hepatitis and there was a significant correlation between the ET-1 level and the stage in CHB patients. 相似文献18.
Nicolas Franchitto Fabien Despas Marc Labrunee Angelica Vaccaro Elisabeth Lambert Gavin Lambert Michel Galinier Jean-Michel Senard Atul Pathak 《International journal of cardiology》2013
Background
We sought to assess whether cardiorenal anemia syndrome (CRAS) in chronic heart failure (CHF) patients contributes to sympathetic overactivity through modulation of sympathetic reflexes.Methods and results
We prospectively studied 15 patients with CRAS and CHF and 15 control CHF patients, matched for age, gender distribution, type of cardiomyopathy, left ventricular ejection fraction (LVEF) and BMI. We compared muscle sympathetic nerve activity (MSNA) and the effect of peripheral chemoreflex deactivation on MSNA in both groups. We also compared sympathetic baroreflex function, assessed by the slope of the relationship between MSNA and diastolic blood pressure in both groups and while peripheral chemoreflexes were (by breathing 100% oxygen for 15 min) or not deactivated. Baseline MSNA was significantly elevated in CHF patients with CRAS compared with control CHF patients (83.1 ± 4.6 versus 64.9 ± 2.9 bursts/100 heart beats; P < 0.05) and sympathetic baroreflex impaired (2.69 ± 0.44 vs 5.25 ± 0.60% bursts/mm Hg; P < 0.01). Chemoreflex deactivation with administration of 100% oxygen led to a significant decrease in muscle sympathetic nerve activity (77.8 ± 4.7 versus 82.1 ± 4.9 bursts/100 heart beats; P < 0.01) and to an increase in sympathetic baroreflex function (2.77 ± 0.45 vs 5.63 ± 0.73% bursts/mm Hg; P < 0.01) in patients with CRAS and CHF. In contrast, neither room air nor 100% oxygen changed MSNA, hemodynamic or sympathetic baroreflex function in control CHF patients.Conclusions
CRAS in CHF patients is associated with elevated sympathetic activity mediated by both tonic activation of peripheral chemoreflex and baroreflex impairment. 相似文献19.
A.V. Mattioli A. FarinettiC. Miloro P. PedrazziG. Mattioli 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2011,21(6):412-417
Background and aims
Coffee and caffeine are widely consumed in Western countries. Little information is available on the influence of coffee and caffeine consumption on atrial fibrillation (AF) in hypertensive patients. We sought to investigate the relationship between coffee consumption and atrial fibrillation with regard to spontaneous conversion of arrhythmia.Methods and results
A group of 600 patients presenting with a first known episode of AF was investigated, and we identified 247 hypertensive patients. The prevalence of nutritional parameters was assessed with a food frequency questionnaire. Coffee and caffeine intake were specifically estimated. Left ventricular hypertrophy was evaluated by electrocardiogram (ECG) and echocardiogram. Coffee consumption was higher in normotensive patients. High coffee consumers were more frequent in normotensive patients compared with hypertensive patients. On the other hand, the intake of caffeine was similar in hypertensive and normotensive patients, owing to a higher intake in hypertensive patients from sources other than coffee. Within normotensive patients, we report that non-habitual and low coffee consumers showed the highest probability of spontaneous conversion (OR 1.93 95%CI 0.88-3.23; p = 0.001), whereas, within hypertensive patients, moderate but not high coffee consumers had the lowest probability of spontaneous conversion (OR 1.13 95%CI 0.67-1.99; p = 0.05).Conclusion
Coffee and caffeine consumption influence spontaneous conversion of atrial fibrillation. Normotensive non-habitual coffee consumers are more likely to convert arrhythmia within 48 h from the onset of symptoms. Hypertensive patients showed a U-shaped relationship between coffee consumption and spontaneous conversion of AF, moderate coffee consumers were less likely to show spontaneous conversion of arrhythmia. Patients with left ventricular hypertrophy showed a reduced rate of spontaneous conversion of arrhythmia. 相似文献20.
Wang C Tan H Yu H Zhang X Suo L Lu Z Pu S Yu Y 《Diabetes research and clinical practice》2011,91(1):67-71