Increased serum oxidative stress in patients with severe mitral regurgitation: A new finding and potential mechanism for atrial enlargement

ObjectiveThe aim of this study was to examine the serum oxidative stress in patients with severe mitral regurgitation.Design and methodsThis study analyzed serum oxidative stress index in patients with severe mitral regurgitation [persistent atrial fibrillation (AF) or sinus rhythm], paroxysmal lone AF patients and healthy subjects.ResultsThe serum oxidative stress index was significantly higher in the mitral regurgitation AF group and sinus group than in the lone AF group and healthy subjects (p < 0.0001). Left atrial size was significantly larger in the mitral regurgitation AF group and sinus group than in the lone AF group and healthy subjects (p < 0.0001). The oxidative stress index significantly and positively correlated with left atrial size in the overall study population (r = 0.439, p = 0.0008).ConclusionsThis study provides new evidence of increased oxidative stress in human severe mitral regurgitation, probably contributing to atrial enlargement.     

MMP-2 and TIMP-2 gene polymorphisms and susceptibility to atrial fibrillation in Chinese Han patients with hypertensive heart disease

BackgroundMMP-2 and TIMP-2 play important roles in the pathogenesis of arrhythmogenic atrial remodeling, and may contribute to the development and persistence of atrial fibrillation (AF). Functional polymorphisms in the promoter of MMP-2 and TIMP-2 gene may modulate an individual's susceptibility to AF.MethodsA total of 881 hypertensive heart disease patients from Chinese Han population (128 with and 753 without AF) were recruited in this study. The genotypes of the MMP2-1306C>T and -735C>T polymorphisms and TIMP-2 -418G>C polymorphisms were determined using PCR based method. The plasma concentration of TIMP-2 was measured by enzyme-linked immunosorbent assay in a subgroup with 81 patients.ResultsBoth genotype distribution and allele frequency of the TIMP-2 -418G>C polymorphism were significantly different between the AF and control group (P = 0.005 and P = 0.001, respectively). The C allele carriers (GC + CC) had a significantly increased risk of AF compared with the GG homozygotes (odds ratio,1.77, 95% CI 1.21–2.92, P = 0.009) in a logistic regression model after adjustment for age, left atrial dimension, left ventricular mass index, and antihypertensive drugs. The C allele carriers also had reduced levels of plasma TIMP-2 levels compared with GG homozygotes in both AF patients and control subjects. No relationship was found in this cohort between the presence of the MMP-2 -1306C>T and -735C>T polymorphism and AF.ConclusionsThe TIMP-2 -418G>C polymorphism is significantly associated with an increased susceptibility to AF in Chinese Han patients with hypertensive heart disease. The -418C allele, which is associated with a decreased expression of TIMP-2, might be a genetic risk for the development of AF in this cohort.     

A three-dimensional finite element model of human atrial anatomy: New methods for cubic Hermite meshes with extraordinary vertices

High-order cubic Hermite finite elements have been valuable in modeling cardiac geometry, fiber orientations, biomechanics, and electrophysiology, but their use in solving three-dimensional problems has been limited to ventricular models with simple topologies. Here, we utilized a subdivision surface scheme and derived a generalization of the “local-to-global” derivative mapping scheme of cubic Hermite finite elements to construct bicubic and tricubic Hermite models of the human atria with extraordinary vertices from computed tomography images of a patient with atrial fibrillation. To an accuracy of 0.6 mm, we were able to capture the left atrial geometry with only 142 bicubic Hermite finite elements, and the right atrial geometry with only 90. The left and right atrial bicubic Hermite meshes were G1 continuous everywhere except in the one-neighborhood of extraordinary vertices, where the mean dot products of normals at adjacent elements were 0.928 and 0.925. We also constructed two biatrial tricubic Hermite models and defined fiber orientation fields in agreement with diagrammatic data from the literature using only 42 angle parameters. The meshes all have good quality metrics, uniform element sizes, and elements with aspect ratios near unity, and are shared with the public. These new methods will allow for more compact and efficient patient-specific models of human atrial and whole heart physiology.     

Heart-type fatty acid binding protein is an early marker of myocardial damage after radiofrequency catheter ablation

ObjectivesRadiofrequency (RF) ablation of arrhythmias induces myocardial damage and release of biomarkers. This study aimed to assess the kinetics of heart-type fatty acid-binding protein (h-FABP), a cytosolic protein released after myocardial injury incurred by both atrial and ventricular RF ablation, compared to other markers of myocardial injury.Design and methodsh-FABP, cTnI, CK-MB_mass and myoglobin were evaluated in 30 patients with atrial or ventricular tachyarrhythmias before, immediately after and at 3, 6 and 24 h after the procedure.Resultsh-FABP increased immediately after the procedure in all subjects (6.6 ± 1.2 μg/L vs 2.7 ± 0.3, p < 0.001) but increased significantly only in ventricular ablations. The peak of h-FABP significantly correlates with the values of time for mean power of RF application in both the entire patient cohort and in ventricular ablations.Conclusionsh-FABP may be an early parameter for monitoring RF-induced lesions and the site of ablation was relevant for biomarker increase.     

Effect of cardiac rehabilitation on left atrial functions in patients with acute myocardial infarction

BackgroundThe objective of this study was to analyze the effects of cardiac rehabilitation (CR) on the atrial function of patients with acute myocardial infarction (AMI) who had been successfully revascularized through percutaneous coronary intervention (PCI).MethodsForty-two AMI patients having undergone CR were enrolled in this observational study. Assessments were performed before and after 6 weeks of CR. Left atrial strain analysis was carried out by two-dimensional speckle tracking echocardiography. Left ventricular ejection fraction (LVEF) was measured by the biplane Simpson's method. Pulsed-wave Doppler at the tip of mitral valve leaflets enabled us to measure early (E) and late (A) diastolic filling velocities, deceleration time (DT) of early filling velocity and isovolumic relaxation time (IVRT). Left ventricle tissue velocity was measured by tissue Doppler imaging of the lateral mitral annulus (e’) and E/e’ was subsequently calculated. Ratio of E/e’ to left atrium (LA) peak strain was used to estimate LA stiffness.ResultsFollowing CR, LVEF (P = 0.010), LA strain (P < 0.001) and LA stiffness (P = 0.013) all showed improvement, while other parameters remained unchanged.ConclusionPost-AMI cardiac rehabilitation and revascularization by PCI might have favourable effects on LA function.     

SQ4U - a computer tailored smoking relapse prevention program incorporating planning strategy assignments and multiple feedback time points after the quit-attempt: development and design protocol

BackgroundThe SQ4U (Stay Quit for You)-study aims to test the efficacy of two computer tailored smoking relapse prevention programs which incorporate planning strategy assignments and provide tailored feedback at multiple time points after the quit-attempt. The programs differ in the support provided after the quit-attempt. This paper aims to describe the development and design of SQ4U.Methods/designSQ4U-respondents were daily smokers in the 18–65 years age group, who were motivated to quit smoking and willing to make a quit-attempt within 1 month of registration. The study is a randomized controlled trial with three conditions: 1. Control group, 2. Action planning (AP) program, 3. Action planning plus (AP+) program. Respondents in the control group only filled out questionnaires. The AP program consisted of computer tailored baseline feedback based on the I-Change Model and six planning strategy assignments. The AP+ program provided the same program elements as the AP program, but was extended with tailored feedback at eleven time points after the quit-attempt. The feedback targeted (recovery) self-efficacy, planning and negative affect. There were two follow-up measurements at 6 and 12 months after baseline. User experiences and the efficacy of the programs in fostering seven-day point prevalence and continued abstinence were examined using a process evaluation and logistic regression analyses.DiscussionThe present paper outlines the development and design of the SQ4U-study. This study has the potential to provide a new effective computer tailored smoking relapse prevention program as well as insight into effective smoking relapse prevention strategies.     

Application of the sheepskin mattress in clinical care for pressure relieving: a quantitative experimental evaluation

This study aimed at quantitatively evaluating the effectiveness of sheepskin mattress (SSM) in pressure relieving, and then variables of peak pressure (mmHg) (PP), average pressure (AP) and contact area (cm²) (CA) at the total, back, sacrum and heel regions of 18 students supinely lying in a control mattress (CM), standard hospital mattress (SHM), SHM + SSM, SSM + CM and AM + CM were measured and contrasted. Paired-T test with a significant level of .05 shows that: the intervention of SSM significantly increased the total CA of SHM by 395.6 cm² and lowered its PP and AP by 8.8 and 2.0 mmHg respectively; further, the pressure distribution of SSM + CM was superior to that of AM + CM. The reliability of this study, with exception of the heel area, was proven to be good. Overall, the sheepskin mattress is an effective product in pressure reliving.     

Expression pattern of NMDA receptors reveals antiepileptic potential of apigenin 8-C-glucoside and chlorogenic acid in pilocarpine induced epileptic mice

The present study was aimed to evaluate the effect of apigenin 8-C-glucoside (Vitexin) and chlorogenic acid on epileptic mice induced by pilocarpine and explored its possible mechanisms. Intraperitonial administration of pilocarpine (85 mg/kg) induced seizure in mice was assessed by behavior observations, which is significantly (p > 0.05) reduced by apigenin 8-C-glucoside (AP8CG) (10 mg/kg) and chlorogenic acid (CA) (5 mg/kg), similar to diazepam. Seizure was accompanied by an imbalance in the levels of Gamma-aminobutyric acid (GABA) and glutamate in the pilocarpine administered group. Moreover, convulsion along with reduced acetylcholinesterase, increased monoamine oxidase and oxidative stress was observed in epileptic mice brain. AP8CG and CA significantly restored back to normal levels even at lower doses. Further, increased lipid peroxidation and nitrite content was also significantly attenuated by AP8CG and CA. However, CA was found to be more effective when compared to AP8CG. In addition, the mRNA expression of N-methyl-d-aspartate receptor (NMDAR), mGluR1 and mGlu5 was significantly (P ≤ 0.05) inhibited by AP8CG and CA in a lower dose. The mRNA expression of GRIK1 did not differ significantly in any of the group and showed a similar pattern of expression. Our result shows that AP8CG and CA selectively inhibit NMDAR, mGluR1 and mGlu5 expression. Modification in the provoked NMDAR calcium response coupled with neuronal death. Hence, these findings underline that the polyphenolics, AP8CG and CA have exerted antiepileptic and neuroprotective activity by suppressing glutamate receptors.     

Quantifying the in vivo quasi-static response to loading of sub-dermal tissues in the human buttock using magnetic resonance imaging

BackgroundThe design of seating systems to improve comfort and reduce injury would benefit from improved understanding of the deformation and strain patterns in soft tissues, particularly in the gluteal region.MethodsTen healthy men were positioned in a semi-recumbent posture while their pelvic and thigh region was scanned using a wide-bore magnetic resonance imaging (MRI) scanner. Independent measurements of deformation for muscles and fat were taken for the transition from non-weight-bearing to weight-bearing loads in three stages. A weight-bearing load was achieved through having the subject supported by a flat, rigid surface. A non-weight-bearing condition was achieved by removing the support under the left buttock, leaving all soft tissue layers undeformed. An intermediate condition partially relieved the subject's left buttock by lowering the support relative to the pelvis by 20 mm, which left the buttock partially deformed. For each of these conditions, the thicknesses of muscle and fat tissues below the ischial tuberosity and the greater trochanter were measured from the MRI data.FindingsIn this dataset, the greatest soft tissue deformation took place below the ischial tuberosity, with muscles (mean = 17.7 mm, SD = 4.8 mm) deforming more than fat tissues (mean = 4.3 mm, SD = 5.6 mm). Muscles deformed through both steps of the transition from weight-bearing to non-weight-bearing conditions, while subcutaneous fat deformed little after the first transition from non-weight-bearing to partial-weight-bearing. High inter-subject variability in muscle and fat tissue strains was observed.InterpretationOur findings highlight the importance of considering inter-subject variability when designing seating systems.     

Blood–brain barrier integrity in a rat model of emergency preservation and resuscitation

Emergency Preservation and Resuscitation (EPR) represents a novel approach to treat exsanguination cardiac arrest (CA) victims, using an aortic flush to induce hypothermia during circulatory arrest, followed by delayed resuscitation with cardiopulmonary bypass (CPB). The status of the blood–brain barrier (BBB) integrity after prolonged hypothermic CA is unclear. The objective of this study was to assess BBB permeability in two EPR models in rats, associated with poor outcome. Rats subjected to traumatic brain injury (TBI) and naïve rats served as positive and negative controls, respectively.HypothesisThe BBB will be disrupted after TBI, but intact after prolonged hypothermic CA.MethodsFour groups were studied: (1) EPR-IC (ice cold)-75 min CA at 15 °C; (2) EPR-RT (room temperature)-20 min CA at 28 °C; (3) TBI; (4) sham. Rats in EPR groups were subjected to rapid hemorrhage, followed by CA. Rats in the TBI group had a controlled cortical impact to the left hemisphere. Naïves were subjected to the same anesthesia and surgery. 1 h after insult, rats were injected with Evans Blue (EB), a marker of BBB permeability for albumin. Rats were sacrificed after 5 h and EB absorbance was quantified in brain samples.ResultsTBI produced an approximately 10-fold increase in EB absorbance in the left (injured) hemisphere vs. left hemisphere for all other groups (p = 0.001). In contrast, EB absorbance in either EPR group did not differ from sham.ConclusionBBB integrity to albumin is not disrupted early after resuscitation from prolonged CA treated with EPR. Neuroprotective adjuncts to hypothermia in this setting should focus on agents that penetrate the BBB. These findings also have implications for deep hypothermic circulatory arrest.     

Percutaneous left ventricular assist device can prevent acute cerebral ischaemia during ventricular fibrillation

AimsA percutaneous left ventricular assist device has been shown to be able to perfuse cardiac and cerebral tissues during cardiac arrest and may be a useful supplement to current methods in resuscitation. We wished to assess device-assisted circulation during cardiac arrest with microspheres injections and continuous end-tidal CO₂ monitoring, and used cerebral microdialysis to detect ischaemia in the brain.Methods12 anaesthetised pigs had microdialysis and pressure catheters implanted via craniotomy. The percutaneous assist device was deployed transfemorally. Ventricular fibrillation was induced by angioplasty-balloon occlusion of the left coronary artery. Cerebral microdialysis samples representing 0–20 and 20–40 min of cardiac arrest with assisted circulation were analysed for markers of cerebral injury (glucose, pyruvate, lactate, and glycerol).ResultsMicrodialysis showed no ischaemic changes after 20 min of cardiac arrest (P = NS to Baseline for glucose, glycerol, lactate, pyruvate and lactate/pyruvate ratio) in subjects with maintained end-tidal CO₂ values above 1.3 kPa (10 mmHg). After 40 min only lactate showed a significant change compared to Baseline (P < 0.05). Microspheres flow to the brain was 57% and myocardial flow was 72% compared to Baseline after 15 min (P < 0.05). After 45 min flow declined to 22% and 40% of Baseline, respectively (P = NS vs. 15 min).ConclusionsA percutaneous left ventricular assist device may prevent ischaemic cerebral injury during cardiac arrest for a limited time. Cerebral injury and tissue perfusion were indicated by end-tidal CO₂.     

Neural correlates of healing prayers,depression and traumatic memories: A preliminary study

Depression is a global health concern and when rooted in childhood adversity is particularly difficult to treat. In a previous study, we found that healing prayer was effective in reducing depressive symptoms.Subjects suffering with depression according to HAM-D scores underwent task-based brain functional MRI (fMRI) prior to and after a 6-week prayer intervention, and depression symptoms were assessed at both time points and at a 12-month follow-up.Average HAM-D scores decreased from 21.6 ± 3.0 prior to the intervention to 4.0 ± 2.7 immediately afterwards (14 subjects) and remained low (3.7 ± 3.4) at 12-month follow-up (11 subjects). fMRI demonstrated increased activity in the medial prefrontal cortex during focus on the traumatic memory after the prayer intervention. Changes in activity in the left inferior frontal gyrus correlated with improvement in depressive symptoms. Activity in the precuneus region decreased after the prayer intervention when subjects focused on the negative feelings associated with the trauma.We conclude that increased activity in the prefrontal cortex after healing prayer may be associated with increased cognitive control over emotions. Healing prayer may help to dissociate the memory of the trauma from feelings associated with it, as evidenced by changes in the precuneus region.     

3D reconstruction of the lumbar vertebrae from anteroposterior and lateral dual-energy X-ray absorptiometry

Current vertebral fracture prevention measures use Dual-energy X-ray Absorptiometry (DXA) to quantify the density of the vertebrae and subsequently determine the risk of fracture. This modality however only provides information about the projected Bone Mineral Density (BMD) while the shape and spatial distribution of the bone determines the strength of the vertebrae. Quantitative Computed Tomography (QCT) allows for the measurement of the vertebral dimensions and volumetric densities, which have been shown to be able to determine the fracture risk more reliably than DXA. However, for the high cost and high radiation dose, QCT is not used in clinical routine for fracture risk assessment. In this work, we therefore propose a method to reconstruct the 3D shape and density volume of lumbar vertebrae from an anteroposterior (AP) and lateral DXA image used in clinical routine. The method is evaluated for the L2, L3 and L4 vertebra. Of these vertebrae a statistical model of the vertebral shape and density distribution is first constructed from a large dataset of QCT scans. All three models are then simultaneously registered onto both AP and lateral DXA image. The shape and volumetric BMD at several regions of the reconstructed vertebrae is then evaluated with respect to the ground truth QCT volumes. For the L2, L3 and L4 vertebrae respectively the shape was reconstructed with a mean (2RMS) point-to-surface distance of 1.00 (2.64) mm, 0.93(2.52) mm and 1.34(3.72) mm and a strong correlation (r > 0.82) was found between the trabecular volumetric BMD extracted from the reconstructions and from the same subject QCT scans. These results indicate that the proposed method is able to accurately reconstruct the 3D shape and density volume of the lumbar vertebrae from AP and lateral DXA, which can potentially improve the fracture risk estimation accuracy with respect to the currently used DXA derived areal BMD measurements.     

Combined use of urinary neutrophil gelatinase-associated lipocalin (uNGAL) and albumin as markers of early cardiac damage in primary hypertension

BackgroundNeutrophil Gelatinase-Associated Lipocalin (NGAL) is an early and specific marker of acute kidney dysfunction. Recent evidences suggest that NGAL may also be involved in chronic vascular remodeling during the development of atherosclerosis. Albuminuria, a powerful predictor of cardiovascular events, is thought to reflect widespread subclinical vascular abnormalities. We investigated the relationship between urinary NGAL (uNGAL), albuminuria and left ventricular mass (LVM) in patients with primary hypertension.MethodsA total of 120 untreated, non diabetic patients with primary hypertension (mean age 47 ± 9 years) were studied. uNGAL was measured by a chemiluminescent microparticle method, optimized on a fully automated analytical platform (ARCHITECT, Abbott Diagnostics Inc, Rome, IT). Albuminuria was measured by immunonephelometry on an Immage Immunochemistry System (Beckman Coulter, Inc., Fullerton, California, USA) and expressed as albumin/creatinine ratio (ACR). LVM was assessed by echocardiography and indexed to body surface area (LVM/BSA).ResultsNo significant correlation was found between uNGAL and ACR; however, both variables were directly related to clinic systolic blood pressure (rho = 0.241, p = 0.0085 and rho = 0.248, p = 0.0068 respectively), left ventricular relative wall thickness (rho = 0.251, p = 0.0156 and rho = 0.263, p = 0.0013 respectively), and LVM/BSA (rho = 0.285, p = 0.0062 and rho = 0.213, p = 0.0410 respectively). The uNGAL and ACR simultaneous increase above their respective median values was associated with higher LVM/BSA values (p = 0.0109) and with a higher prevalence of left ventricular hypertrophy (LVH) (p = 0.0017). Furthermore, logistic regression analysis showed that the risk of presenting LVH increased more than 4-fold when uNGAL and ACR were both above the median value, even after adjustment for age, gender and blood pressure values.ConclusionsThe simultaneous increase in uNGAL and ACR excretion is significantly associated with the increase of LVM in low risk patients with primary hypertension. This association is clinically significant for the early assessment of cardiac damage in hypertension.     

Fluvastatin combined with benazepril may contribute to the favorable prognosis of patients with atrial fibrillation

The aim of this study was to observe the clinical efficacy of fluvastatin combined with benazepril in the treatment of patients with atrial fibrillation (AF). A total of 92 patients with AF were randomly assigned to the case group (n = 46), in which the patients were treated with fluvastatin (80 mg) plus benazepril (10 mg), or to the control group (n = 46), in which the patients were treated with fluvastatin (80 mg). The conversion rate of sinus rhythm was higher in the case group than in the control group (P < 0.05). The case group had more treatment-effective patients than the control group, with fewer treatment-ineffective patients (P < 0.05). The LVEDd, LVESd, LAD, and LVEF indexes in the case group were lower than in the control group after 6 months of treatment (all P < 0.05). Levels of hs-CRP were also lower in patients in the case group than in patients in the control group after 1 month of treatment (P < 0.05). After 12 months, renin and Ang II concentrations were lower in patients in the case group than in the control group (both P < 0.05). Significant differences in IL-6 and TNF-α expression were found between the two groups after 1 month, 6 months, and 12 months of treatment (all P < 0.05). Compared to patients in the control group, the levels of total cholesterol (TC), triglycerides, and LDL-C in the case group were lower after 6 and 12 months of treatment (all P < 0.05), while the HDL level was higher (P < 0.05). Treatment with fluvastatin combined with benazepril further increased the conversion rate of sinus rhythm and significantly improved the quality of life and prognosis of AF patients.     

The impact of acute atrial fibrillation on the prothrombotic state in patients with essential hypertension

ObjectivesTo investigate whether acute atrial fibrillation (AF) creates a prothrombotic state in hypertensive patients, and to assess the evolution in research indices after cardioversion.Design and methodsPlasma levels of von Willebrand factor (vWf), soluble P-selectin and fibrin D-dimers were measured in hypertensive patients with acute AF pre-cardioversion and at 1, 7, 14, and 30 days post-cardioversion. The results were compared with hypertensive controls and healthy controls.ResultsPre-cardioversion plasma vWf levels in acute AF patients were similar to those of controls; however, post-cardioversion, the vWf levels increased significantly and only returned to baseline levels 14 days later. Compared with controls, acute AF patients had higher levels of fibrin D-dimers, which lasted at least 14 days after cardioversion.ConclusionsThis study demonstrated that hypertensive patients with acute AF have an abnormal prothrombotic state, which persists for up to 14 days after cardioversion.     

Drug-induced thrombocytopenia after anticoagulation with rivaroxaban

A 66-year-old man presented to the emergency department with complaints of dark-colored stool and rash developing over the last couple of days. The patient was started on rivaroxaban and flecainide for months prior for atrial fibrillation. Upon arrival, he was awake, alert, and oriented with a blood pressure of 111/63 mm Hg, heart rate of 68 beats per minute, and oxygen saturation of 96% on room air. A review of systems was unremarkable with the exception of skin rash and light-headedness. The patient's initial laboratory results were significant for red blood cell (RBC) count of 4.05 × 10⁶/mcL, hemoglobin of 12.1 g/dL, hematocrit of 35.6%, and platelet count of 1 × 103/mcL. Aggressive hydration was started in the ED, initially with two 1-L boluses of normal saline followed by an infusion of 10 mL/h. One unit of platelets was transfused. Rivaroxaban and flecainide were held on admission. Twenty-four hours after admission, the patient was initiated on immune globulin (IVIG) Gammagard (Baxter, West Lake, CA), 75 g on 3 consecutive days and steroids for possible immune thrombocytopenia. His platelet count steadily improved over the 6-day period to 119 × 103/mcL on the day of hospital discharge. This is the second reported case of possible rivaroxaban-induced thrombocytopenia.     

Effect of modified bridge exercise on trunk muscle activity in healthy adults: a cross sectional study

Design

This is a cross-sectional study.

Dynamic variations in platelet counts may reflect the severity and prognosis of stingray injuries in the early phase

There is often a delay in offering quality and prompt treatment after a stingray sting. We present 3 cases of stings and discuss the Poisoning Severity Score (PSS) and a simple tool to assess the severity of such injuries. A 34-year-old man, who worked as an aquarium keeper, presented a wound on the left fifth digit caused by a stingray. Acute myocardial injury and rhabdomyolysis were detected. After 6 weeks, the wound had almost healed. A 27-year-old man who experienced a stingray injury on the left second digit recovered without sequelae after 5 weeks. A 45-year-old man with a history of diabetes, who was accidentally stung in the right palm by a stingray, experienced rhabdomyolysis and returned to work after 2 months. We performed debridement, administered the tetanus toxoid and antibiotics, and immersed the wounded hand in warm water (about 43 °C) for all three cases. Meanwhile, patients with rhabdomyolysis were administered intravenous hydration. Upon presentation at the emergency department, we recorded the severity of the injury by using PSS. We found that relatively high PSSs were associated with lower platelet counts that happen due to various adverse events. We suggest that dynamic changes in platelet counts may be associated with the severity of the injury. Furthermore, lower platelet counts in the normal or abnormal range may indicate poor prognoses.     

The association between transforming growth factor β3 polymorphisms and left ventricular structure in hypertensive subjects

BackgroundTransforming growth factor β (TGF-β) may be a crucial regulator of cardiac remodeling. We investigated the association between the TGF-β gene polymorphisms and left ventricular structure.MethodsA total of 658 hypertensive subjects were genotyped for the TGF-β1 T869C and TGF-β3 (rs3917187 and rs4252338) polymorphisms.ResultsTGF-β3 rs3917187 AA homozygotes had, while accounting for covariates, greater left ventricular end-systolic (LVESD, P = 0.004) and end-diastolic dimension (LVEDD, P = 0.007) than G allele carriers. Moreover, left ventricular mass index (LVMI) in AA genotype was 123.0 ± 3.1 g/m² significantly higher than that in AG (114.6 ± 1.6 g/m²) and GG (115.4 ± 2.1 g/m², P = 0.03) genotypes. In multivariate regression analysis, TGF-β3 rs3917187 genotype as an independent predictor had statistically significant effects on LVESD (β = 0.164, P = 0.002), LVEDD (β = 0.172, P = 0.003) and LVMI (β = 0.136, P = 0.016), respectively. In further analyses, we observed a significant interaction between the rs3917187 and alcohol intake in relation to LVESD (P_int = 0.04) and left ventricular fractional shortening (LVFSH, P_int = 0.012). However, no relationship could be found between left ventricular parameters and the T869C or the rs4252338.ConclusionThe present results demonstrated that the TGF-β3 rs3917187 polymorphism was associated with left ventricular structure, and had an interactive influence with alcohol on LVESD and LVFSH in hypertensive subjects.