1
|
Silva Júnior JGD, Araújo HDAD, Rocha IGD, Silva Neto JCD, Oliveira RN, Assis SPD, Lima VLDM. Antihyperlipidemic activity of glycoconjugated phthalimides in mice submitted to a model of dyslipidemia and insulin resistance. Chem Biodivers 2022; 19:e202200119. [PMID: 36094678 DOI: 10.1002/cbdv.202200119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 09/08/2022] [Indexed: 11/07/2022]
Abstract
Alterations in lipid and lipoprotein metabolism are factors that trigger several negative metabolic complications. Hyperlipidemia is the starting point for the development of comorbidities of the cardiovascular system, such as atherosclerosis. The search for compounds that reduce high levels of total cholesterol and triglycerides has been widely reported in several publications in the literature. Phthalimide derivatives have been extensively researched with various biological actions. In this study we evaluated the antihyperlipidemic ability of three phthalimide derivatives (FGT-2, FGT-3 and FGT-4) on a model of obesity and insulin resistance in mice. The animals were submitted to a hyperlipid diet for 60 days. On the thirtieth day they were treated with phthalimides (20 mg/kg). The positive control group was treated with Simvastatin (20 mg/kg) and the negative control received only the carboxymethylcellulose vehicle. Biochemical and histological analyzes of all groups were analyzed. The animals treated with phthalimidic derivatives had a reduction in total cholesterol, low density and very low density lipoproteins (LDL-c and VLDL-c), triglycerides and fasting glycemia when compared to the negative control group. The treated animals also showed good results when analyzing the atherogenic indexes Castelli i and II and the ratio Triglycerides/HDL-c. In the oral glucose tolerance test and in the insulin tolerance test, animals treated with phthalimides were more sensitive to the action of the hormone regulating carbohydrate uptake. In the evaluation of the transaminases (AST/ALT), the animals of the group treated with phthalimides presented a lower elevation than the other groups of the experiment, the same observed with the uric acid evaluation. Histological analyzes were performed on liver, kidney, heart and pancreas samples. The groups treated with the compounds FGT-2 and FGT3 presented discrete alterations in the liver and kidney. FGT-4 did not present histological alterations for both tissues and the three phthalimide derivatives did not cause alterations in the other organs. These results suggest that the phthalimides tested can act as antihyperlipidemic agents and have a pleiotropic action, by acting also reducing glycemia in insulin resistance model mimicking diabetes mellitus type 2. These compounds may appear as a new approach in the treatment of obesity and complications, which are multifaceted.
Collapse
Affiliation(s)
- José Guedes da Silva Júnior
- Universidade Federal de Pernambuco, Bioquímica, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife - PE,, 50670-901, Recife, BRAZIL
| | - Hallysson Douglas Andrade de Araújo
- Universidade Federal de Pernambuco, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, 50670-901, Recife, BRAZIL
| | - Ismael Gomes da Rocha
- Universidade Federal de Pernambuco, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, 50670-901, Recife, BRAZIL
| | - Jacinto Costa da Silva Neto
- Universidade Federal de Pernambuco, Departamento de Histologia e Embriologia, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, 50670-901, Recife, BRAZIL
| | - Ronaldo Nascimento Oliveira
- Universidade Federal Rural de Pernambuco, Departamento de Ciências Moleculares, Rua Dom Manuel de Medeiros, s/n - Dois Irmãos, Recife, BRAZIL
| | - Shalom Porto de Assis
- Universidade Católica de Pernambuco: Universidade Catolica de Pernambuco, Departamento de Química, Rua do Príncipe, 526 - Boa Vista, Recife, BRAZIL
| | - Vera Lúcia de Menezes Lima
- Universidade Federal de Pernambuco, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, BRAZIL
| |
Collapse
|
2
|
Zhao X, Chen G, Zhou Y, Nashalian A, Xu J, Tat T, Song Y, Libanori A, Xu S, Li S, Chen J. Giant Magnetoelastic Effect Enabled Stretchable Sensor for Self-Powered Biomonitoring. ACS NANO 2022; 16:6013-6022. [PMID: 35417654 DOI: 10.1021/acsnano.1c11350] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Interfacing with the human body, wearable and implantable bioelectronics are a compelling platform technology for healthcare monitoring and medical therapeutics. However, clinical adoption of these devices is largely shadowed by their weakness in humidity resistance, stretchability, durability, and biocompatibility. In this work, we report a self-powered waterproof biomechanical sensor with stretchability up to 440% using the giant magnetoelastic effect in a soft polymer system. By manipulating the magnetic dipole alignment, the sensor achieved a particularly broad sensing range from 3.5 Pa to 2000 kPa, with a response time of ∼3 ms. To validate the excellent performance of the magnetoelastic sensor in biomonitoring, both ex vivo porcine heart testing and in vivo rat model testing were performed for cardiovascular monitoring and heart disease diagnosis. With the obtained sensing data, we have successfully detected ventricular arrhythmia and ventricular fibrillation in the Sprague-Dawley rat model. Holding a collection of compelling features, including minimal hysteresis, ultrawide sensing range, waterproofness, and biocompatibility, the magnetoelastic sensor represents a unique platform technology for self-powered biomonitoring in both wearable and implantable manners.
Collapse
Affiliation(s)
- Xun Zhao
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Guorui Chen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Yihao Zhou
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Ardo Nashalian
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Jing Xu
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Trinny Tat
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Yang Song
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Alberto Libanori
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Shili Xu
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095, United States
- Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095, United States
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Song Li
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Jun Chen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| |
Collapse
|
3
|
Zhang Y, Feng X, Du M, Ding J, Liu P. Salvianolic acid B attenuates the inflammatory response in atherosclerosis by regulating MAPKs/ NF-κB signaling pathways in LDLR-/- mice and RAW264.7 cells. Int J Immunopathol Pharmacol 2022; 36:3946320221079468. [PMID: 35285334 PMCID: PMC9118216 DOI: 10.1177/03946320221079468] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objectives: Salvianolic acid B (Sal B) is the main effective water-soluble
component of Salvia miltiorrhiza. In this study, the anti-inflammatory
effect of Sal B was explored in high-fat-diet (HFD)-induced LDLR-/- mice and oxidized
low-density-lipoprotein (ox-LDL)-induced or lipopolysaccharide (LPS)-induced RAW264.7
cells. Methods: The LDLR-/- mice were randomly divided into four groups after
12 weeks of high-fat diet. Then, the mice were administrated with 0.9% saline or Sal B
(25 mg/kg) or Atorvastatin (1.3 mg/kg) for 12 weeks. RAW 264.7 cells were induced with
ox-LDL/LPS, or ox-LDL/LPS plus different concentrations of Sal B (1.25 μg/mL, 2.5 μg/mL,
5 μg/mL), or ox-LDL plus Sal B plus MAPKs activators. ELISA was used for detecting serum
lipid profiles and inflammatory cytokines, RT-qPCR used for gene expression, Oil Red O
used for plaque sizes, and immunofluorescence staining used for NF-κB p65 and TNF-α
production. Inflammation-related proteins and MAPKs pathways were detected by Western
Blot. Results: The results showed that Sal B decreased the levels of serum
lipids (TC, TG, and LDL-C), attenuated inflammatory cytokines, and improved lipid
accumulation in the aorta. Sal B also attenuated the elevation of inflammatory cytokines
induced by ox-LDL or LPS in RAW264.7 cells, and the phosphorylation of MAPKs/NF-κB
pathways in the aorta and RAW264.7 cells, resulting in a significant decrease in the
contents of p-JNK, p-ERK 1/2, p-P38, p-IκB, and p-NF-κB p65. Conclusions: Sal
B could exert anti-inflammatory effects on atherosclerosis via MAPKs/NF-κB signaling
pathways in vivo and in vitro.
Collapse
Affiliation(s)
- Yifan Zhang
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoteng Feng
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Du
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jie Ding
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ping Liu
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| |
Collapse
|
4
|
Zheng Q, Tang Q, Wang ZL, Li Z. Self-powered cardiovascular electronic devices and systems. Nat Rev Cardiol 2020; 18:7-21. [PMID: 32895536 DOI: 10.1038/s41569-020-0426-4] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2020] [Indexed: 01/24/2023]
Abstract
Cardiovascular electronic devices have enormous benefits for health and quality of life but the long-term operation of these implantable and wearable devices remains a huge challenge owing to the limited life of batteries, which increases the risk of device failure and causes uncertainty among patients. A possible approach to overcoming the challenge of limited battery life is to harvest energy from the body and its ambient environment, including biomechanical, solar, thermal and biochemical energy, so that the devices can be self-powered. This strategy could allow the development of advanced features for cardiovascular electronic devices, such as extended life, miniaturization to improve comfort and conformability, and functions that integrate with real-time data transmission, mobile data processing and smart power utilization. In this Review, we present an update on self-powered cardiovascular implantable electronic devices and wearable active sensors. We summarize the existing self-powered technologies and their fundamental features. We then review the current applications of self-powered electronic devices in the cardiovascular field, which have two main goals. The first is to harvest energy from the body as a sustainable power source for cardiovascular electronic devices, such as cardiac pacemakers. The second is to use self-powered devices with low power consumption and high performance as active sensors to monitor physiological signals (for example, for active endocardial monitoring). Finally, we present the current challenges and future perspectives for the field.
Collapse
Affiliation(s)
- Qiang Zheng
- CAS Center for Excellence in Nanoscience, Beijing Key Laboratory of Micro-Nano Energy and Sensor, Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, China.,School of Nanoscience and Technology, University of Chinese Academy of Sciences, Beijing, China
| | - Qizhu Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhong Lin Wang
- CAS Center for Excellence in Nanoscience, Beijing Key Laboratory of Micro-Nano Energy and Sensor, Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, China. .,School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
| | - Zhou Li
- CAS Center for Excellence in Nanoscience, Beijing Key Laboratory of Micro-Nano Energy and Sensor, Beijing Institute of Nanoenergy and Nanosystems, Chinese Academy of Sciences, Beijing, China. .,School of Nanoscience and Technology, University of Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
5
|
Gaiz A, Mosawy S, Colson N, Singh I. Thrombotic and cardiovascular risks in type two diabetes; Role of platelet hyperactivity. Biomed Pharmacother 2017; 94:679-686. [PMID: 28787703 DOI: 10.1016/j.biopha.2017.07.121] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/19/2017] [Accepted: 07/24/2017] [Indexed: 12/20/2022] Open
Abstract
One of the most commonly identified chronic illnesses in many countries is type 2 diabetes mellitus (T2DM). T2DM denotes an independent risk factor for cardiovascular disease (CVD). Heart disease is one of the causes of mortality in patients with diabetes, mainly due to the macrovascular complications. One of these macrovascular complications in diabetes is atherosclerosis, which involves a complicated pathophysiological process. Besides hyperglycemia, oxidative stress plays a significant role in the pathogenesis of diabetes and its associated risk of CVD. There are many other factors including molecular, metabolic, lipid, fibrinolytic, and platelet function disorders precipitate to thrombotic and CVD risks in T2DM. Also, Platelets have an increased response to procoagulants in patients with diabetes. Platelet hyperactivity, in the presence of oxidative stress, has a major effect on the progression of thrombotic and CVD events. This review will discuss the impact of the above factors and the potential effects of platelet hyperactivity on thrombotic and cardiovascular risks.
Collapse
Affiliation(s)
- Almottesembellah Gaiz
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parkland Drive, Southport, Queensland, 4222, Australia; National Centre of Hematology, Almustansiriah University, Alyarmook, Baghdad, Iraq.
| | - Sapha Mosawy
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parkland Drive, Southport, Queensland, 4222, Australia
| | - Natalie Colson
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parkland Drive, Southport, Queensland, 4222, Australia
| | - Indu Singh
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parkland Drive, Southport, Queensland, 4222, Australia
| |
Collapse
|
6
|
Saadatirad A, Sardari S, Kazemali M, Zarei N, Davami F, Barkhordari F, Adeli A, Mahboudi F. Expression of a novel chimeric-truncated tPA in Pichia pastoris with improved biochemical properties. Mol Biotechnol 2016; 56:1143-50. [PMID: 25143123 DOI: 10.1007/s12033-014-9794-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Thrombolytic therapy by plasminogen activators (PAs) has been a main goal in the treatment of acute myocardial infarction. Despite improved outcomes of currently available thrombolytic therapies, all these agents have different drawbacks that may result in less than optimal outcomes. In order to make tissue plasminogen activator (tPA) more potent, while being more resistant to plasminogen activator inhibitor-1 (PAI-1) and having a higher affinity to fibrin, a new chimeric-truncated form of tPA (CT tPA) was designed and expressed in Pichia pastoris. This novel variant consists of a finger domain of Desmoteplase, an epidermal growth factor (EGF) domain, a kringle 1 (K1) domain, a kringle 2 (K2) domain, in which the lysine binding site (LBS) was deleted, and a protease domain, where the four amino acids lysine 296, arginine 298, arginine 299, and arginine 304 were substituted by aspartic acid. The chimera CT tPA showed 14-fold increase in its activity in the presence of fibrin compared to the absence of fibrin. Furthermore, CT tPA showed about 10-fold more potency than commercially available full-length tPA (Actylase(®)) and provided 1.2-fold greater affinity to fibrin. A residual activity of only 68 % was observed after incubation of Actylase(®) with PAI-1, however, 91 % activity remained for CT tPA. These promising findings suggest that the novel CT tPA variant might be an acceptable PA with superior characteristics and properties.
Collapse
Affiliation(s)
- Amirhossein Saadatirad
- Biotechnology Research Center, Pasteur Institute of Iran (IPI), No. 69, Pasteur Avenue, Tehran, 1316943551, Iran
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Expression of a novel chimeric truncated t-PA in CHO cells based on in silico experiments. J Biomed Biotechnol 2010; 2010:108159. [PMID: 20885932 PMCID: PMC2946600 DOI: 10.1155/2010/108159] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Revised: 08/01/2010] [Accepted: 08/16/2010] [Indexed: 11/18/2022] Open
Abstract
Tissue plasminogen activator (t-PA) is one of the fibrin-specific serine proteases that play a crucial role in the fibrinolytic system. The rapid clearance of the drug from the circulation, caused by its active uptake in the liver, has lead to complicated clinical applications. Different forms of plasminogen activators have been developed to treat thrombotic disease. Deletion of the first three domains of t-PA by gene manipulation techniques has shown a significant increase in its plasma half life. In order to compensate the disadvantage of higher bleeding risk, a novel chimeric truncated form of t-PA with 394 amino acids and more fibrin affinity compared to the truncated form was designed to be expressed in Chinese Hamster Ovarian (CHO) cells. The recombinant chimeric plasminogen activator consists of kringle 2 and serine protease (K2S) domains of t-PA, namely GHRP-SYQ-K2S. The level of expression was found to be 752 IU/ml with 566,917 IU/mg specific activity, based on amidolytic activity. The fibrin binding of this novel chimeric truncated t-PA was 86% of the full length t-PA at a fibrinogen concentration of 0.2 mg/ml. This could be a promising approach with more desirable pharmacodynamic properties compared to existing commercial forms.
Collapse
|
8
|
Alves RMDA, Thomaz RP, Almeida EAD, Wanderley JDS, Guariento ME. Chagas' disease and ageing: the coexistence of other chronic diseases with Chagas' disease in elderly patients. Rev Soc Bras Med Trop 2010; 42:622-8. [PMID: 20209343 DOI: 10.1590/s0037-86822009000600002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Accepted: 11/12/2009] [Indexed: 11/22/2022] Open
Abstract
This study aimed to identify the main comorbidities in elderly chagasic patients treated in a reference service and identify possible associations between the clinical form of Chagas' disease and chronic diseases. Ninety patients aged 60 years-old or over were interviewed and their clinical diagnoses recorded. The study population profile was: women (55.6%); median age (67 years); married (51.1%); retired (73.3%); up to four years' education (64.4%); and earning less than two minimum wages (67.8%). The predominant forms of Chagas' disease were the cardiac (46.7%) and mixed forms (30%). There was a greater proportion of mild cardiac dysfunction (84.1%), frequently in association with megaesophagus. The mean number of concurrent diseases was 2.856 +/- 1.845, and 33% of the patients had four or more comorbidities. The most frequent were systemic arterial hypertension (56.7%), osteoporosis (23.3%), osteoarthritis (21.2%) and dyslipidemia (20%). Positive correlations were verified between sex and comorbidities and between age group and comorbidities.
Collapse
Affiliation(s)
- Rosalía Matera de Angelis Alves
- Grupo de Estudos em Doença de Chagas, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP.
| | | | | | | | | |
Collapse
|
9
|
Maziak W, Rastam S, Mzayek F, Ward KD, Eissenberg T, Keil U. Cardiovascular health among adults in Syria: a model from developing countries. Ann Epidemiol 2007; 17:713-20. [PMID: 17553700 PMCID: PMC1994693 DOI: 10.1016/j.annepidem.2007.03.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 02/19/2007] [Accepted: 03/09/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE Despite the considerable mortality and morbidity associated with cardiovascular disease (CVD), many developing countries lack reliable surveillance of these ailments and their risk factors to guide intervention. This study aims to provide the first population-based estimates of CVD morbidity and mortality among adults in Aleppo, Syria and the distribution of their risk factors. METHODS A cross-sectional survey of adults 18 to 65 years old residing in Aleppo, Syria was carried out in 2004, involving 2038 household representatives (45.2% men; mean age, 35.3 years; response rate, 86%). Main outcomes of interest were physician-diagnosed CVD (infarction, angina, failure, stroke) among survey participants, and past 5-year mortality due to CVD among their household members older than 20 years of age (N = 6252, 49.5% men). Measurement of blood pressure (BP), height and weight, and smoking history were obtained as well. RESULTS Prevalence of CVD was 4.8% for heart disease and 1.0% for stroke. CVD was responsible for 45.0% of overall mortality reported in the past 5 years, whereby 49% of CVD deaths occurred before the age of 65 years. Mean age of death was 62.6 years (63.6 years for heart disease and 61.4 years for stroke). Annual crude death rate due to CVD was 314 per 100,000 (95% confidence interval [95% CI]: 215-414); of these, 179 were due to heart disease, and 135 due to stroke. More men than women died from heart disease, whereas the opposite was true for stroke. Hypertension was detected in 40.6% (47.7% men, 34.9%women), obesity in 38.2% (28.8% men, 46.4% women), and smoking (cigarettes or waterpipe) in 38.7% (63.6% men, 19.2% women) of participants. Of those surveyed, 39.3% had one CVD risk factor, 27.4% had two risk factors, and 8.3% had 3 risk factors. Main predictors of clustering of risk factors were older age, male gender, and low education. CONCLUSIONS Syria is currently undergoing a stage in which morbidity and mortality from CVD are high but likely to increase based on the population's risk profile. CVD risk distribution in Syrian society highlights the non-generalizability of CVD models from developed societies, and calls for local studies to inform effective interventions and policies.
Collapse
Affiliation(s)
- Wasim Maziak
- Department of Health & Sport Sciences, University of Memphis, TN 38152, USA.
| | | | | | | | | | | |
Collapse
|
10
|
Carr ZA, Land CE, Kleinerman RA, Weinstock RW, Stovall M, Griem ML, Mabuchi K. Coronary heart disease after radiotherapy for peptic ulcer disease. Int J Radiat Oncol Biol Phys 2005; 61:842-50. [PMID: 15708264 DOI: 10.1016/j.ijrobp.2004.07.708] [Citation(s) in RCA: 144] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2004] [Accepted: 07/12/2004] [Indexed: 12/23/2022]
Abstract
PURPOSE To evaluate the risk of coronary heart disease (CHD) and cerebrovascular disease after radiotherapy (RT) for peptic ulcer disease. METHODS AND MATERIALS Peptic ulcer disease patients treated with RT (n = 1859) or by other means (n = 1860) at the University of Chicago Medical Center between 1936 and 1965, were followed through 1997. The observed numbers of cause-specific deaths were compared with the expected numbers from the general population rates. During RT, 5% of the heart was in the treatment field and the remainder of the heart mostly received scattered radiation. A volume-weighted cardiac dose was computed to describe the average tissue dose to the entire organ. We used Cox proportional hazards regression analysis to analyze the CHD and cerebrovascular disease risk associated with RT, adjusting for confounding factors. RESULTS Greater than expected CHD mortality was observed among the irradiated patients. The irradiated patients received volume-weighted cardiac doses ranging from 1.6 to 3.9 Gy and the portion of the heart directly in the field received doses of 7.6-18.4 Gy. The CHD risk increased with the cardiac dose (p trend = 0.01). The cerebrovascular disease risk was not associated with the surrogate carotid dose. CONCLUSION The excess CHD risk in patients undergoing RT for peptic ulcer disease decades previously indicates the need for long-term follow-up for cardiovascular disease after chest RT.
Collapse
Affiliation(s)
- Zhanat A Carr
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH/DHHS, 6120 Executive Boulevard, EPS 7038, Rockville, MD 20852, USA
| | | | | | | | | | | | | |
Collapse
|