H-FABP, cardiovascular risk factors, and functional status in asymptomatic spinal cord injury patients

Background

This was a cross-sectional study in the setting of a rehabilitation hospital.

Objective

The aim of the study was to determine the serum levels of heart-type fatty acid-binding protein (H-FABP) in patients with spinal cord injury (SCI). A further goal was to examine whether there is a relationship between H-FABP levels and Functional Ambulation Classification (FAC) scale, Functional Independence Measure (FIM) score, American Spinal Injury Association (ASIA) status, and metabolic syndrome (MetS).

Methods

The study included 56 SCI patients and 37 age- and sex-matched healthy control subjects who had not been diagnosed with coronary artery disease in the past.

Results

Serum H-FABP levels were significantly higher in patients with SCI than in control subjects: paraplegia group, 18.5?±?11.4; tetraplegia group, 16.3?±?9.1; control group, 6.7?±?5.1 ng/ml (p?<?0.001). There was no difference between the other cardiac enzymes (troponin I, AST, ALT, CK, CK-MB, and LDH) among the groups. The relationship between the serum H-FABP levels and FAC status was examined. There was a negative correlation between FAC status and H-FABP levels (p?<?0.001, r?=???0.581). Patients with complete SCI were divided into two groups according to the level of the lesion: (lesion levels in C6–T6, n?=?25; lesion levels in T7–L2, n?=?11). In patients with complete motor injury, H-FABP levels were higher in subjects with injuries above T6 than in those with injuries below T6 (24.21?±?10.1 and 14.1?±?10.4, respectively; p?=?0.011). Serum levels of H-FABP were higher in SCI patients with MetS (n?=?10) than in those without MetS (n?=?46; 25.8?±?11.6 ng/ml vs. 16.42?±?10.3 ng/ml, respectively; p?=?0.014). Patients were then divided into two groups according to SCI duration: <?12 months (n?=?27) and >?12 months (n?=?29). H-FABP levels showed statistically significant differences between the two groups (14.8?±?11.7 ng/dl and 20.9?±?9.9 ng/dl, respectively; p?=?0.036).

Conclusion

H-FABP is related to MetS and FAC status in asymptomatic SCI patients.     

Intravascular evaluation of coronary atherosclerotic lesions among Egyptian diabetic patients with acute coronary syndromes

Background

Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF).

Renal impairment and coronary collaterals in patients with acute coronary syndrome

Objective

We aimed to elucidate the relationship between mild-to-moderate renal impairment and the development of coronary collateral vessels (CCV) in patients with acute coronary syndrome (ACS).

Methods

We enrolled 461 patients with ACS who underwent coronary angiography for the first time. The development of CCV was assessed with the Rentrop score. Kidney function was classified according to the estimated glomerular filtration rate (eGFR). The Gensini score was used to show the extent of atherosclerosis.

Results

The mean eGFR value was 89.9?±?24.3 U/l for patients with no development of collaterals and 82.7?±?20.5 for patients who had CCV. The mean age was 59?±?11 years and 349 patients (75.7?%) were male. Rentrop classifications 1-2-3 (presence of CCV) were determined in 222 (48.1?%) patients. The presence of CCV was significantly associated with low levels of eGFR (p?=?0.001), increased serum creatinine levels (p?=?0.034), high levels of serum albumin (0.036), and the Gensini score (p?<?0.001). Multivariate analysis showed that the Gensini score was an independent predictor of the presence of CCV (OR?=?1.090, 95?% CI: 1.032–1.151, p?=?0.002).

Conclusion

We suggest that the association between mild-to-moderate renal impairment and the presence of CCV may be explained by increased myocardial ischemia and severe CAD.     

Substrate metabolism during basal and hyperinsulinemic conditions in adolescents and young-adults with Barth syndrome

Background

Barth syndrome (BTHS) is a rare X-linked disorder that is characterized by mitochondrial abnormalities, infantile or childhood onset of cardioskeletal myopathy, and high mortality rates. It is currently unknown if BTHS related mitochondrial dysfunction results in substrate metabolism abnormalities and thereby contributes to cardioskeletal myopathy in patients with BTHS.

Methods

Adolescents and young adults with BTHS (n?=?5, 20?±?4 yrs) and age and activity matched healthy controls (n?=?5, 18?±?4 yrs) underwent an hyperinsulinemic-euglycemic clamp procedure with stable isotopically labeled tracers for measurement of lipolysis, fatty acid oxidation, glucose disposal, and whole-body proteolysis rates; dual energy x-ray absorptiometry for measurement of body composition and 2-D and strain echocardiography for measurement of left ventricular function.

Results

Participants with BTHS had lower fat-free mass (FFM) (BTHS: 31.4?±?6.9 vs. Control: 46.7?±?5.3 kg, p?<?0.005), lower systolic function (strain, BTHS: -15.2?±?2.4 vs. Control: ?19.0?±?2.4 %, p?<?0.05), greater insulin-stimulated glucose disposal rate per kg FFM (BTHS: 96.5?±?16.3 vs. Control: 67.4?±?17.6 μmol/kgFFM/min, p?<?0.05), lower basal (BTHS: 4.6?±?2.7 vs. Control: 11.9?±?4.4 μmol/kgFM/min, p?<?0.05) and hyperinsulinemic (BTHS: 1.6?±?0.4 vs. Control: 3.6?±?1.6 μmol/kgFM/min, p?<?0.05) lipolytic rate per kg fat mass (FM), and a trend towards higher basal leucine rate of appearance per kg FFM (BTHS: 271.4?±?69.3 vs. Control: 193.1?±?28.7 μmol/kgFFM/hr, p?=?0.07) compared to controls. Higher basal leucine rate of appearance per kg FFM (i.e. whole-body proteolytic rate) tended to be associated with lower left ventricular systolic strain (r?=??0.57, p?=?0.09).

Conclusion

Whole-body fatty acid, glucose and amino acid metabolism kinetics when expressed per unit of body composition are altered and appear to be related to cardioskeletal myopathy in humans with BTHS. Further studies examining myocardial substrate metabolism and whole-body substrate metabolism during increased energy demands (e.g., exercise) and their relationships to skeletal and cardiac function are recommended.     

Coronary vessel diameters during and after primary percutaneous coronary artery intervention

Background

Primary percutaneous coronary intervention (P-PCI) is the gold standard treatment for acute coronary syndromes. Plasma levels of catecholamines and other vasopressors are elevated during acute myocardial infarction (AMI) and coronary vasoconstriction is frequent. We aimed to compare the reference vessel diameter (RVD) of the infarct-related artery (IRA) during primary PCI and after an average of 3 days.

Methods

Coronary angiography (CAG) was performed on 58 patients with acute ST-segment elevation myocardial infarction (STEMI) and TIMI 3 flow after P-PCI (43 men, 15 women; mean age, 55.5?±?10 years). TIMI 3 flow was achieved either by simple balloon dilatation and/or thrombus aspiration. Lesion length, RVD, minimal lumen diameter (MLD), mean vessel diameter (meanD), and area of stenosis were compared during P-PCI and follow-up CAG.

Results

RVD, MLD, and meanD values were significantly higher during the follow-up CAG than after P-PCI (RVD 2.7?±?0.7 mm vs. 2.9?±?0.7 mm, p?=?0.001; MLD 1.5?±?0.5 mm vs. 1.7?±?0.4 mm, p?=?0.002; meanD 2.2?±?0.5 mm vs. 2.4?±?0.5 mm, p?=?0.001). Area of stenosis values were significantly lower during the follow-up CAG than after primary PCI (69.5?±?16.5?% vs. 62.1?±?15?%, p?=?0.001). Lesion lengths were not statistically significant during the follow-up CAG and primary PCI (lesion length 24.0?±?10.8 mm vs. 22.1?±?8.8 mm, p?>?0.05).

Conclusion

This study showed that RVD was higher at the follow-up CAG a few days after AMI in patients who had TIMI 3 flow after P-PCI with simple balloon dilatation and/or thrombus aspiration. A delay of a few days for stent implantation in P-PCI allows for larger-diameter stent use and may help to reduce stent thrombosis and restenosis rates.     

Relationship between fragmented QRS complexes and left ventricular systolic and diastolic functions

Background

Fragmented QRS complexes (fQRS) have been associated with increased morbidity and mortality, sudden cardiac death, and recurrent cardiovascular events. The association between left ventricular systolic and diastolic functions and presence of fragmented QRS has not been comprehensively studied to date. We tested the hypothesis that the presence of fragmented QRS is associated with left ventricular systolic and diastolic dysfunction.

Methods

The study included 259 patients who were consecutively admitted to our outpatient clinic for cardiovascular risk factor management. Extensive echocardiographic parameters were obtained from all patients and these were compared with the presence and number of fQRS.

Results

Patients with fQRS were of older age (58?±?12 vs. 55?±?13 years, p?=?0.03) and had prolonged QRS time (105?±?12 vs. 93?±?10 ms, p?<?0.001) and a higher rate of Q waves on ECG (36% vs. 11%, p?<?0.001). In addition, they had worse systolic (lower LVEF%, 44?±?17 vs. 61?±?12, p?<?0.001) and diastolic functions (DT, 177?±?77 vs. 211?±?59 ms, p?<?0.001; IVRT, 81?±?27 vs. 92?±?22 ms, p?=?0.001; E_m, 9?±?4 vs. 10?±?4 cm/s, p?=?0.008; E/E_m ratio, 11?±?5 vs. 8?±?4, p?<?0.001) in comparison to patients with nonfragmented QRS. There was a significant negative correlation between the number of fQRS and left ventricle systolic functions (for LVEF%, r?=???0.595, p?<?0.001). After adjustment for age and gender, the number of fQRS remained significantly negatively associated with left ventricular systolic and diastolic functions.

Conclusion

We found that fQRS is related to left ventricular systolic dysfunction and diastolic dysfunction. fQRS, which may be the result of myocardial ischemia or scar on myocardial electrical parameters at the cellular level, may represent inadequate systolic and diastolic functions.     

Clinical significance of aortic stiffness,carotid intima-media thickness and serum osteoprotegerin level in rheumatoid arthritis patients

Aim of the work

Cardiovascular diseases represent a major source of morbidity and mortality for patients with rheumatoid arthritis (RA). The increase in aortic stiffness, carotid intima-media thickness (CIMT) and serum osteoprotegerin (OPG) have been shown to be independent risk factors for cardiovascular events. This work aimed to investigate the clinical significance of these parameters in RA patients.

Hybrid training of voluntary and electrical muscle contractions reduces steatosis, insulin resistance, and IL-6 levels in patients with NAFLD: a pilot study

Background

Physical inactivity is a risk factor for the development of non-alcoholic fatty liver disease (NAFLD). ??Hybrid training??, a training that involves both voluntary and electrical muscle contractions, causes beneficial alterations in muscles even after short durations of exercise. The aim of this study was to investigate the therapeutic efficacy of hybrid training in patients with NAFLD.

Methods

Thirty-five patients with NAFLD who were resistant to lifestyle counseling were assigned to a hybrid-training group (n?=?12) or a control group (n?=?23). In the hybrid-training group, quadriceps and hamstrings were contracted voluntarily or electrically for 19?min twice a week. In the control group, patients received lifestyle counseling. The therapeutic efficacy of the hybrid training was evaluated after 12?weeks of the intervention.

Results

Serum alanine aminotransferase (ALT) levels and hepatic steatosis grade were significantly decreased in the hybrid-training group compared to that of the control group (?14.1?±?5.8 vs. 3.5?±?5.4?IU/mL; P?<?0.05, ?0.67?±?0.19 vs. 0.09?±?0.06 grade; P?<?0.01, respectively). No significant changes were seen between the two groups in skeletal muscle mass. The decreases in homeostasis model assessment of insulin resistance (HOMA-IR) value and in serum IL-6 levels were significantly greater in the hybrid-training group than in the control group (?6.2?±?3.2 vs. 0.4?±?0.6; P?<?0.05, ?3.1?±?1.1 vs. 1.1?±?0.5?pg/mL; P?<?0.01, respectively).

Conclusion

Hybrid training of voluntary and electrical muscle contractions improved hepatic steatosis and reduced insulin resistance and serum IL-6 levels in NAFLD patients who are resistant to lifestyle counseling.     

Mitral regurgitation recovery and atrial reverse remodeling following pulmonary vein isolation procedure in patients with atrial fibrillation: a clinical observation proof-of-concept cardiac MRI study

Background

Reverse remodeling of the left atrium (LA) following successful pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) has been well documented. However, mitral regurgitation (MR) recovery after successful PVI has never been demonstrated systematically. The objective of our study was to retrospectively analyze the effectiveness of PVI in patients with AF on recovery of MR using cardiac magnetic resonance (CMR) imaging.

Methods

Prior to PVI, patients underwent a clinically indicated CMR imaging. Post-PVI (6?±?2 months), patients underwent a follow-up MRI and were classified into two groups—responders (R) and non-responders (NR) to PVI—as assessed by cessation of AF at the end of the prespecified 6-month (14-day “P” sensitive event monitor defined) follow-up period. Furthermore, CMR was used to evaluate the severity of MR (0 to 4+) and to relate changes in MR to LA volumes as well as mitral apparatus geometry. Patients who had mild and higher MR (2+) on baseline CMR and had a post-PVI CMR were selected for final analysis.

Results

Out of the consecutive 122 patients with AF who underwent PVI, 74 patients that had mitral regurgitation on initial CMR were included in the study. Of these74 patients with AF with MR, 52 (70 %) were classified as R and 22 (30 %) were classified as NR. Baseline demographics were similar between the groups. In the subgroup with mild to severe MR, pre vs. post in the R group MR severity significantly improved (mean?=?2.3, median?=?2.0 vs. mean?=?1.0, median?=?1.0, p?<?0.0001) and was matched by favorable reverse remodeling of the mitral apparatus geometry (annulus?=?35?±?4 vs. 33?±?3 mm, p?<?0.002; tenting area?=?175?±?56 vs.137?±?37 mm², p?<?0.003; tenting height?=?8?±?2 vs.7?±?2 mm, p?<?0.02; and tenting angle?=?129?±?10° vs. 131?±?11°, p?=?0.1). However, in the NR subgroup, MR failed to improve (mean?=?2.2, median?=?2.0 vs. mean?=?1.5, median?=?1.0, p?=?NS) and paralleled general failure of mitral geometry reverse remodeling (annulus?=?35?±?4 vs. 35?±?4 mm, p?=?0.2; tenting area?=?153?±?39 vs. 152?±?34 mm², p?=?NS; tenting height?=?7?±?1 vs. 7.0?±?2, p?=?0.1; and tenting angle?=?131?±?11° vs. 133?±?10°, p?=?NS). In those with lesser degrees of MR, favorable remodeling was predicated on responder status to PVI. Similarly, other cardiac dimensions pre- to post-PVI favorably improved in the R group, but not in the NR group.

Conclusion

In those with durable maintenance of normal sinus rhythm (NSR), cardiac reverse remodeling demonstrated by 3D CMR occurs and is matched by marked improvements in MR and mitral apparatus, likely contributing to continued maintenance of NSR.     

Platelet distribution width and saphenous vein disease in patients after CABG

Objective

Platelets are involved in the pathogenesis of atherosclerosis. The inflammatory process in atherosclerosis may cause an increase in red blood cell distribution width (RDW) and platelet distribution width (PDW) values. Therefore, in this study we aimed to investigate whether PDW and RDW are associated with the patency of saphenous vein graft in patients at least 1 year after coronary artery bypass graft (CABG) surgery.

Methods

Patients who had undergone CABG surgery at least 1 year previously with at least one saphenous vein graft were included in the study population. Patients were referred to cardiac catheterization for stable anginal symptoms or positive stress test results. Before coronary angiography, all patients referred had routine blood tests including RDW and PDW values.

Results

Saphenous vein grafts were found to be patent in 69 patients and occluded in 40 patients. Although RDW levels were similar between patients with patent and occluded grafts (13.1?±?1.1% and 13.2?±?0.7% respectively, p?=?0.37), PDW levels were significantly different between the two groups (13.1?±?1.3% and 14.1?±?1.1 respectively, p?=?0.03). Although time after CABG operation differs significantly between the two groups (p?<?0.001), multiple logistic regression analyses showed that PDW levels were found to be significantly associated with the patency of vein graft (β?=?1.682, 95% CI 1.117–2.532, p?=?0.013).

Conclusion

Our results showed that PDW levels were higher in patients with an occluded saphenous vein graft. However no association was found between the saphenous vein graft disease and RDW values. To verify this relationship between PDW values and saphenous vein graft patency, further investigations are needed.     

Increased H-FABP concentrations in nonalcoholic fatty liver disease

Aim

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder which is reported as the hepatic manifestation of metabolic syndrome with an increased risk of cardiovascular events. Patients with NAFLD are also at risk of future cardiac events independently of metabolic syndrome. The aim of this study was to examine serum concentrations of heart type fatty acid binding protein (H-FABP) in NAFLD and to investigate its correlations with metabolic parameters and subclinical atherosclerosis.

Patients and methods

A total of 34 patients with NAFLD and 35 healthy subjects were enrolled in the study. NAFLD patients had elevated liver enzymes and steatosis graded on ultrasonography. Healthy subjects had normal liver enzymes and no steatosis on ultrasonography. H-FABP levels were measured using an enzyme linked immunosorbent assay (ELISA) method and correlations with metabolic parameters and subclinical atherosclerosis were examined. Subclinical atherosclerosis was determined with carotid artery intima–media thickness (CIMT) which was measured by high resolution B mode ultrasonography.

Results

H-FABP levels were elevated in patients with NAFLD (16.3?±?4.0 ng/ml) when compared with healthy controls (13.8?±?2.1 ng/ml; p??<?0.001). NAFLD patients had significantly higher CIMT than the controls had (0.64?±?0.17 mm vs. 0.43?±?0.14 mm, p?=?0.009). The H-FABP concentrations were significantly positively correlated with body mass index (r?=?0.255, p?=?0.042), fasting blood glucose level (r?=?0.300, p?=?0.013), CIMT (r?=?0.335, p?=?0.043), and homeostasis model assessment-estimated insulin resistance (HOMA-IR; r?=?0.156, p?=?0.306). In multiple linear regression analysis, H-FABP levels were only independently associated with CIMT (p?=?0.04)

Conclusion

Serum H-FABP concentrations increase in patients with NAFLD. Our results may not only suggest that H-FABP is a marker of subclinical myocardial damage in patients with NAFLD but also of subclinical atherosclerosis, independent of metabolic syndrome and cardiac risk factors.     

Primäre Prävention des Typ-2-Diabetes durch Lebensstilmodifikation

Background

Large landmark studies, such as the Finnish Diabetes Prevention Study (DPS) and the American Diabetes Prevention Program (DPP) could conclusively show that prevention of type 2 diabetes or a significant delay in the manifestation of diabetes is possible by lifestyle modifications in persons with an increased risk of diabetes. However, the lifestyle interventions in these studies were carried out in a relatively resource-intensive individual setting and measures were employed which are far too costly to be implemented in practice. A group approach is clearly more economical and less resource-intensive.

Aim

The objective of this prospective, randomized trial was to investigate whether the results of the large, high-quality clinical trials for the prevention of type 2 diabetes could be translated into practical affordable interventions that are deliverable in the real world healthcare system in Germany. The effectiveness of the newly developed Prevention of Diabetes Self-Management Program (PREDIAS) for groups was investigated for people with increased risk of diabetes with respect to a successful weight reduction after 1 year.

Material and methods

The PREDIAS group program for lifestyle modification and primary prevention of type 2 diabetes consists of 12 course-hours extending over a period of 12 months. A total of 182 persons with an elevated diabetes risk participated in this study and were randomly assigned to the intervention group (PREDIAS) or the control group (CG). Patients in the CG received written information about diabetes prevention.

Results

After 12 months participants in the PREDIAS program achieved a significantly higher average weight loss than the CG (??3.8?±?5.2 kg versus ??1.4?±?4.0 kg, p?=?0.001). Fasting glucose was reduced in the PREDIAS group, whereas it rose slightly in the CG (??4.3?±?11.3 mg/dl versus 1.8?±?13.1 mg/dl, p?=?0.001). The duration of physical activity per week was significantly increased in the PREDIAS group than in the CG (46.6?±?95.5 min/week versus 17.9?±?63.8 min/week, p=0.034). Indicators of a modified eating behavior also showed a significantly greater improvement in PREDIAS than in the CG (cognitive restraint 3.9?±?3.8 versus 1.5?±?4.7, p?=?0.001 and disinhibition ??1.2?±?2.7 versus ??0.4?±?2.6, p?=?0.049). There were no significantly greater improvements with regard to lipids or blood pressure in the PREDIAS group compared with the CG.

Conclusion

The improvements in the risk factors achieved with the PREDIAS group program were broadly equivalent to the 1 year data of the DPP or the DPS, which were both conducted in an extensive and time-consuming individual setting.     

Novel adipokines vaspin and irisin as risk biomarkers for cardiovascular diseases in type 2 diabetes mellitus

Aims

Vaspin and irisin are novel cytokines proposed as potential new biomarkers of insulin resistance and endothelial dysfunction. This work is to investigate circulating levels of vaspin and irisin in patients with type 2 diabetes mellitus (T2DM) with and without cardiovascular disease (CVD) to study potential association with disease risk.

Conduction characteristics in atrial fibrillation

Background

Atrial fibrillation (AF) is one of the most common arrhythmias observed in clinical practice. The frequency of AF is increased in patients with impaired interatrial conduction. We aimed to investigate whether tissue Doppler echocardiography could be used for the evaluation of atrial conduction characteristics instead of an electrophysiological study, and to examine the predictive accuracy of tissue Doppler echocardiography for the inducibility of sustained AF.

Methods

We enrolled 86 consecutive patients who underwent an electrophysiological study. We performed electrocardiographic P wave dispersion, M-mode, two-dimensional, Doppler, and tissue Doppler echocardiography as well as an electrophysiological study (EPS) to evaluate the intra- and interatrial conduction times. We tried to induce AF, and the patients were categorized according to the inducibility of sustained (>?120 s) AF.

Results

We found a good correlation between intra-left atrial conduction time detected by tissue Doppler echocardiography (ILCT-echo) and by EPS (ILCT-eps; r?=?0.744, p?<?0.001), and a weak correlation between interatrial conduction times (IACT-echo and IACT-eps, r?=?0.396, p?<?0.001). In patients with inducible sustained AF, P wave dispersion (46?±?19 ms vs. 27?±?18, p?<?0.001), ILCT-echo (29?±?10 ms vs. 17?±?7 ms, p?<?0.001), and IACT-eps (47?±?11 ms vs. 36?±?13 ms, p?<?0.001) were found to be higher than those of the noninducible/nonsustained AF group. These three parameters were independent predictors of the inducibility of sustained AF.

Conclusion

We demonstrated that ILCT-echo could be used instead of ILCT-eps for the evaluation of left atrial conduction characteristics. We also showed that ILCT-eps could be a valuable parameter for predicting the development of long-lasting AF.     

Influence of the right- versus left-sided sleeping position on the apnea-hypopnea index in patients with sleep apnea

Purpose

Sleep and sleep position have a significant impact on physical, cardiac and mental health, and have been evaluated in numerous studies particularly in terms of lateral sleeping positions and their association with diseases. We retrospectively examined the relationship between the sleeping position and position-specific apnea-hypopnea index (AHI) in obstructive sleep apnea-hypopnea (OSA) patients.

Methods

We assessed the sleeping body position and the body position-specific AHI score in patients who were referred for suspected OSA and underwent diagnostic nocturnal polysomnography. In order to eliminate inter-individual differences, only those who had a similar percentage of time spent in the LSSP and RSSP for each patient were enrolled. To provide this validity, only subjects that had a similar percentage of left and right lateral sleep time (±10%) were included in the analysis.

Results

A total of 864 patients had nocturnal diagnostic PSG. Of them, 131 patients met the inclusion criteria. The percent rate spent in the supine sleeping position (SSP) was 31.3?±?18.7%, in the LSSP was 31.8?±?10% and in the RSSP was 32.6?±?10.8%. Whereas the SSP-specific AHI score was the highest with 60.4?±?36.2/h among all the sleeping position-specific AHI scores (p?<?0.001), the LSSP-specific AHI score was statistically higher than that for RSSP (30.2?±?32.6/h vs. 23.6?±?30.1/h; p?<?0.001). When comparing individuals sub-grouped based on OSA severity, there was a statistically significant difference between the LSSP-specific AHI score and RSSP-specific AHI score in patients with severe (p?=?0.002) and moderate (p?=?0.026), but not mild (p?=?0.130) OSA.

Conclusion

We found that the sleeping position had a significant influence on apneic events and RSSP decreased the frequency of obstructive respiratory events in patients with moderate and severe disease.     

Association of epicardial fat thickness with TIMI risk score in NSTEMI/USAP patients

Background

The association of epicardial adipose tissue (EAT) with coronary artery disease has been shown in previous studies. Furthermore, the relationship between EAT and acute coronary syndrome was studied recently. Herein, we investigated the relationship between EAT thickness and the thrombolysis in myocardial infarction (TIMI) risk score for non-ST-elevation myocardial infarction (NSTEMI) and unstable angina pectoris (USAP).

Patients and methods

The study included 144 patients with NSTEMI/USAP. The study population was divided into two subgroups according to TIMI risk scores as group I (≤?4, n?=?86) and group II (>?4, n?=?58). Stepwise multivariable logistic regression analysis was used to assess the independent association of clinical parameters with TIMI risk score.

Results

EAT thickness was higher in group II than in group I (8.2?±?2.1 vs. 6.2?±?2.2, p?Conclusion In conclusion, EAT thickness is independently associated with TIMI risk score and may be an emerging risk factor for adverse events in NSTEMI/USAP patients.     

Bolus injection of newly synthesized vitamin E derivative ETS-GS for the treatment of acute severe ulcerative colitis in a mouse model

Purpose

Vitamin E with its antioxidant action has therapeutic effects on ulcerative colitis (UC), but use of vitamin E is limited because of its insolubility in water. We developed ETS-GS (γ-l-glutamyl-S-[2-[[[3,4-dihydro-2,5,7,8-tetramethyl-2-(4,8,12-trimethyltri-decyl)-2?H-1-benzopyran-6-yl]oxy]carbonyl]-3-oxo-3-[(2-sulfoethyl)amino]propyl]-l-cysteinylglycine sodium salt), a newly synthesized soluble vitamin E derivative with strong antioxidant action. We evaluated the therapeutic effects of bolus injection of ETS-GS on acute severe UC in a mouse model.

Methods

An animal model of acute severe UC was induced by feeding mice 5 % dextran sulfate sodium (DSS) for 5 days, followed by 1 % DSS on days 5–8, the experimental period. ETS-GS or saline was administered by subcutaneous bolus injection during the experimental period. We examined disease activity index (DAI) score, histological score, colon length, colon weight, and serum cytokines in the mice.

Results

The following results at day 8 in the DSS + ETS-GS group were significantly lower than those in the DSS + Saline group: DAI score, 2.6?±?0.6 vs. 3.1?±?0.5; histological score, 2.1?±?1.0 vs. 3.1?±?0.8; serum interleukin (IL)-6, 15?±?9.4 vs. 39?±?23 pg/ml; and keratinocyte-derived chemokine (KC), 122?±?61 vs. 228?±?66 pg/ml (P?<?0.05). Colon length, colon weight, and serum IL-10 in the DSS + ETS-GS group were significantly higher than those in the DSS + Saline group (88?±?12 vs. 75?±?5.7 mm, 0.48?±?0.09 vs. 0.38?±?0.05 g, and 55?±?18 vs. 31?±?10 pg/ml, respectively; P?<?0.05).

Conclusions

Bolus injection of ETS-GS may be one therapeutic modality for acute severe UC. Its effects are associated with suppression of serum IL-6 and serum KC and promotion of serum IL-10.     

急性冠状动脉综合征患者血浆组织因子和白细胞介素18水平的变化及意义

目的观察急性冠状动脉综合征(ACS)患者血浆组织因子和白细胞介素18水平的变化及其关系,探讨凝血与炎症的相关性及其在ACS发生、发展中的作用。方法选择冠心病患者118例,根据诊断分为ACS组67例和稳定性心绞痛组51例,2组患者测定血浆组织因子和白细胞介素18水平,并进行比较,采用Pearson相关分析法分析两变量的相关性。结果 ACS组血浆组织因子和白细胞介素18水平明显高于稳定性心绞痛组[(101.44±21.32)ng/L vs(90.01±19.44)ng/L,(311.73±113.00)ng/L vs(246.59±94.63)ng/L,P<0.01];ACS组血浆组织因子与白细胞介素18呈正相关(r=0.654,P<0.01),稳定性心绞痛组血浆组织因子与白细胞介素18无相关性(P>0.05)。结论 ACS患者体内炎症活动与凝血活动可能互相作用。     

Evaluation of ventricular repolarization features with Tp-e,Tp-e/QTc,JTc and JTd during electroconvulsive therapy

Objective

The purpose of this study was to investigate the influence of electrical stimulation transmitted through the body during electroconvulsive therapy on traditional and relatively new ventricular repolarization parameters (Rate corrected QT interval (QTc), QT dispersion (QTd), rate corrected JT interval (JTc), JT dispersion (JTd), T-peak to T-end interval (Tp-e) and Tp-e/QTc ratio) under propofol anaesthesia.

Increased serum resistin levels in patients with coronary slow-flow phenomenon

Background

Slow coronary flow (SCF) is an angiographic finding characterized by delayed opacification of the epicardial coronary arteries without obstructive coronary disease. Resistin, an adipocytokine, plays a major role besides low-grade inflammation in atherosclerotic vascular processes and may be of importance in other coronary pathologies such as SCF.

Methods

The present study was cross-sectional and observational, consisting of 70 individuals who underwent coronary angiography and had angiographically normal coronary arteries of varying coronary flow rates. The study included 50 patients with isolated SCF and 20 control participants with normal coronary flow (NCF).

Results

There were no statistically significant differences between the SCF and NCF groups with respect to age, gender, presence of hypertension or diabetes mellitus, and smoking habit, except for increased creatinine levels (p?=?0.014). The serum resistin level was significantly higher in the SCF group than in the NCF group (8.4?±?7.2 vs. 5.4?±?2.6 ng/ml, p?=?0.014). Ln-transformed resistin levels correlated positively with left anterior descending (LAD) coronary artery TIMI frame count (TFC) (r?=?0.408, p?<?0.001) as well as with glucose (r?=?0.340, p?=?0.004), creatinine (r?=?0.248, p?=?0.044), and C-reactive protein (CRP; r?=?0.283, p?=?0.023) levels, and negatively with LAD coronary flow velocity (r?=???0.314, p?=?0.009). When multivariate analyses were performed, in linear regression analysis, ln-resistin was associated with a longer TFC [beta (standardized regression coefficient): 0.404, p?=?0.001] and lower coronary flow velocity (beta: ??0.280, p?=?0.035); in logistic regression analysis, ln-resistin was an independent predictor of the presence of SCF (OR: 6.692, 65?%CI: 1.117–40.1, p?=?0.037).

Conclusion

We demonstrated, for the first time, a significant increase in serum resistin levels in patients with SCF compared to subjects with NCF. We believe that further studies are needed to clarify the role of resistin in patients with SCF.