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Abdulmelik A, Tila M, Tekilu T, Debalkie A, Habtu E, Sintayehu A, Dendir G, Gordie N, Daniel A, Suleiman Obsa M. Magnitude and associated factors of intraoperative cardiac complications among geriatric patients who undergo non-cardiac surgery at public hospitals in the southern region of Ethiopia: a multi-center cross-sectional study in 2022/2023. Front Med (Lausanne) 2024; 11:1325358. [PMID: 38695033 PMCID: PMC11061426 DOI: 10.3389/fmed.2024.1325358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/04/2024] [Indexed: 05/04/2024] Open
Abstract
Background Intraoperative cardiac complications are a common cause of morbidity and mortality in non-cardiac surgery. The risk of these complications increased with the average age increasing from 65. In a resource-limited setting, including our study area, the magnitude and associated factors of intraoperative cardiac complications have not been adequately investigated. The aim of this study was to assess the magnitude and associated factors of intraoperative cardiac complications among geriatric patients undergoing non-cardiac surgery. Methods An institutional-based multi-center cross-sectional study was conducted on 304 geriatric patients at governmental hospitals in the southern region of Ethiopia, from 20 March 2022 to 25 August 2022. Data were collected by chart review and patient interviews. Epi Data version 4.6 and SPSS version 25 were used for analysis. The variables that had association (p < 0.25) were considered for multivariable logistic regression. A p value < 0.05 was considered significant for association. Result The overall prevalence of intraoperative cardiac complications was 24.3%. Preoperative ST-segment elevation adjusted odds ratio (AOR = 2.43, CI =2.06-3.67), history of hypertension (AOR = 3.42, CI =2.02-6.08), intraoperative hypoxia (AOR = 3.5, CI = 2.07-6.23), intraoperative hypotension (AOR = 6.2 9, CI =3.51-10.94), age > 85 years (AOR = 6.01, CI = 5.12-12.21), and anesthesia time > 3 h (AOR =2.27, CI = 2.0.2-18.25) were factors significantly associated with intraoperative cardiac complications. Conclusion The magnitude of intraoperative cardiac complications was high among geriatric patients who had undergone non-cardiac surgery. The independent risk factors of intraoperative cardiac complications for this population included age > 85, ST-segment elevation, perioperative hypertension (stage 3 with regular treatment), duration of anesthesia >3 h, intraoperative hypoxia, and intraoperative hypotension. Holistic preoperative evaluation, optimization optimal and perioperative care for preventing perioperative risk factors listed above, and knowing all possible risk factors are suggested to reduce the occurrence of complications.
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Affiliation(s)
- Amina Abdulmelik
- School of Anesthesia, College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Mebratu Tila
- School of Anesthesia, College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Takele Tekilu
- School of Medical Laboratory, College of Medicine and Health Science, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Ashebir Debalkie
- School of Anesthesia, College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Elias Habtu
- School of Anesthesia, College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Ashagrie Sintayehu
- School of Anesthesia, College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Getahun Dendir
- School of Anesthesia, College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Naol Gordie
- School of Anesthesia, College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Abel Daniel
- School of Medicine, College of Medicine and Health Science, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Mohammed Suleiman Obsa
- Department of Anesthesia, College of Medicine and Health Science, Arsi University, Assela, Ethiopia
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Barrère-Lemaire S, Vincent A, Jorgensen C, Piot C, Nargeot J, Djouad F. Mesenchymal stromal cells for improvement of cardiac function following acute myocardial infarction: a matter of timing. Physiol Rev 2024; 104:659-725. [PMID: 37589393 DOI: 10.1152/physrev.00009.2023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/05/2023] [Accepted: 08/16/2023] [Indexed: 08/18/2023] Open
Abstract
Acute myocardial infarction (AMI) is the leading cause of cardiovascular death and remains the most common cause of heart failure. Reopening of the occluded artery, i.e., reperfusion, is the only way to save the myocardium. However, the expected benefits of reducing infarct size are disappointing due to the reperfusion paradox, which also induces specific cell death. These ischemia-reperfusion (I/R) lesions can account for up to 50% of final infarct size, a major determinant for both mortality and the risk of heart failure (morbidity). In this review, we provide a detailed description of the cell death and inflammation mechanisms as features of I/R injury and cardioprotective strategies such as ischemic postconditioning as well as their underlying mechanisms. Due to their biological properties, the use of mesenchymal stromal/stem cells (MSCs) has been considered a potential therapeutic approach in AMI. Despite promising results and evidence of safety in preclinical studies using MSCs, the effects reported in clinical trials are not conclusive and even inconsistent. These discrepancies were attributed to many parameters such as donor age, in vitro culture, and storage time as well as injection time window after AMI, which alter MSC therapeutic properties. In the context of AMI, future directions will be to generate MSCs with enhanced properties to limit cell death in myocardial tissue and thereby reduce infarct size and improve the healing phase to increase postinfarct myocardial performance.
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Affiliation(s)
- Stéphanie Barrère-Lemaire
- Institut de Génomique Fonctionnelle, Université de Montpellier, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
- LabEx Ion Channel Science and Therapeutics, Université de Nice, Nice, France
| | - Anne Vincent
- Institut de Génomique Fonctionnelle, Université de Montpellier, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
- LabEx Ion Channel Science and Therapeutics, Université de Nice, Nice, France
| | - Christian Jorgensen
- Institute of Regenerative Medicine and Biotherapies, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
- Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Christophe Piot
- Département de Cardiologie Interventionnelle, Clinique du Millénaire, Montpellier, France
| | - Joël Nargeot
- Institut de Génomique Fonctionnelle, Université de Montpellier, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
- LabEx Ion Channel Science and Therapeutics, Université de Nice, Nice, France
| | - Farida Djouad
- Institute of Regenerative Medicine and Biotherapies, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
- Centre Hospitalier Universitaire Montpellier, Montpellier, France
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3
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Vijayakumar A, Wang M, Kailasam S. The Senescent Heart-"Age Doth Wither Its Infinite Variety". Int J Mol Sci 2024; 25:3581. [PMID: 38612393 PMCID: PMC11011282 DOI: 10.3390/ijms25073581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/10/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Cardiovascular diseases are a leading cause of morbidity and mortality world-wide. While many factors like smoking, hypertension, diabetes, dyslipidaemia, a sedentary lifestyle, and genetic factors can predispose to cardiovascular diseases, the natural process of aging is by itself a major determinant of the risk. Cardiac aging is marked by a conglomerate of cellular and molecular changes, exacerbated by age-driven decline in cardiac regeneration capacity. Although the phenotypes of cardiac aging are well characterised, the underlying molecular mechanisms are far less explored. Recent advances unequivocally link cardiovascular aging to the dysregulation of critical signalling pathways in cardiac fibroblasts, which compromises the critical role of these cells in maintaining the structural and functional integrity of the myocardium. Clearly, the identification of cardiac fibroblast-specific factors and mechanisms that regulate cardiac fibroblast function in the senescent myocardium is of immense importance. In this regard, recent studies show that Discoidin domain receptor 2 (DDR2), a collagen-activated receptor tyrosine kinase predominantly located in cardiac fibroblasts, has an obligate role in cardiac fibroblast function and cardiovascular fibrosis. Incisive studies on the molecular basis of cardiovascular aging and dysregulated fibroblast function in the senescent heart would pave the way for effective strategies to mitigate cardiovascular diseases in a rapidly growing elderly population.
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Affiliation(s)
- Anupama Vijayakumar
- Cardiovascular Genetics Laboratory, Department of Biotechnology, Bhupat and Jyothi Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036, India;
| | - Mingyi Wang
- Laboratory of Cardiovascular Science, National Institute on Aging/National Institutes of Health, Baltimore, MD 21224, USA;
| | - Shivakumar Kailasam
- Department of Biotechnology, University of Kerala, Kariavattom, Trivandrum 695581, India
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4
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Fayed N, Elkhadry SW, Garling A, Ellerkmann RK. External Validation of the Revised Cardiac Risk Index and the Geriatric-Sensitive Perioperative Cardiac Risk Index in Oldest Old Patients Following Surgery Under Spinal Anaesthesia; a Retrospective Cross-Sectional Cohort Study. Clin Interv Aging 2023; 18:737-753. [PMID: 37197404 PMCID: PMC10183631 DOI: 10.2147/cia.s410207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/02/2023] [Indexed: 05/19/2023] Open
Abstract
Background The Revised Cardiac Risk Index (RCRI) and the Geriatric Sensitive Cardiac Risk Index (GSCRI) estimate the risk of postoperative major adverse cardiac events (MACE) regardless of the type of anesthesia and without specifying the oldest old patients. Since spinal anesthesia (SA) is a preferred technique in geriatrics, we aimed to test the external validity of these indices in patients ≥ 80 years old who underwent surgery under SA and tried to identify other potential risk factors for postoperative MACE. Methods The performance of both indices to estimate postoperative in-hospital MACE risk was tested through discrimination, calibration, and clinical utility. We also investigated the correlation between both indices and postoperative ICU admission and length of hospital stay (LOS). Results The MACE incidence was 7.5%. Both indices had limited discriminative (AUC for RCRI and GSCRI were 0.69 and 0.68, respectively) and predictive abilities. The regression analysis showed that patients with atrial fibrillation (AF) were 3.77 and those with trauma surgery were 2.03 times more likely to exhibit MACE, and the odds of MACE increased by 9% for each additional year above 80. Introducing these factors into both indices (multivariable models) increased the discriminative ability (AUC reached 0.798 and 0.777 for RCRI and GSCRI, respectively). Bootstrap analysis showed that the predictive ability of the multivariate GSCRI but not the multivariate RCRI improved. Decision curve analysis (DCA) showed that multivariate GSCRI had superior clinical utility when compared with multivariate RCRI. Both indices correlated poorly with postoperative ICU admission and LOS. Conclusion Both indices had limited predictive and discriminative ability to estimate postoperative in-hospital MACE risk and correlated poorly with postoperative ICU admission and LOS, following surgery under SA in the oldest-old patients. Updated versions by introducing age, AF, and trauma surgery improved the GSCRI performance but not the RCRI.
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Affiliation(s)
- Nirmeen Fayed
- Anethesia and Critical Care Department, Klinikum Dortmund, Dortmund, Germany
- Anesthesia and Critical Care Department, National Liver Institute Menoufia University, Shebin-Alkoom, Egypt
- Correspondence: Nirmeen Fayed, Anesthesia Department Klinikum Dortmund, Germany, Mollwitzer Straße 4, Dortmund, 44141, Germany, Tel +49 17647154842, Email
| | - Sally Waheed Elkhadry
- Epidemiology and Preventive Medicine Institute, National Liver Institute, Menoufia University, Shebin-Alkoom, Egypt
| | - Andreas Garling
- Anethesia and Critical Care Department, Klinikum Dortmund, Dortmund, Germany
| | - Richard K Ellerkmann
- Anethesia and Critical Care Department, Klinikum Dortmund, Dortmund, Germany
- Anesthesia and Critical Care Department, Bonn University, Bonn, Germany
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5
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Wang Y, Xu Y, Guo W, Fang Y, Hu L, Wang R, Zhao R, Guo D, Qi B, Ren G, Ren J, Li Y, Zhang M. Ablation of Shank3 alleviates cardiac dysfunction in aging mice by promoting CaMKII activation and Parkin-mediated mitophagy. Redox Biol 2022; 58:102537. [PMID: 36436456 PMCID: PMC9709154 DOI: 10.1016/j.redox.2022.102537] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 11/19/2022] Open
Abstract
Compromised mitophagy and mitochondrial homeostasis are major contributors for the etiology of cardiac aging, although the precise underlying mechanisms remains elusive. Shank3, a heart-enriched protein, has recently been reported to regulate aging-related neurodegenerative diseases. This study aimed to examine the role of Shank3 in the pathogenesis of cardiac senescence and the possible mechanisms involved. Cardiac-specific conditional Shank3 knockout (Shank3CKO) mice were subjected to natural aging. Mitochondrial function and mitophagy activity were determined in vivo, in mouse hearts and in vitro, in cardiomyocytes. Here, we showed that cardiac Shank3 expression exhibited a gradual increase during the natural progression of the aging, accompanied by overtly decreased mitophagy activity and a decline in cardiac function. Ablation of Shank3 promoted mitophagy, reduced mitochondria-derived superoxide (H2O2 and O2•-) production and apoptosis, and protected against cardiac dysfunction in the aged heart. In an in vitro study, senescent cardiomyocytes treated with D-gal exhibited reduced mitophagy and significantly elevated Shank3 expression. Shank3 knock-down restored mitophagy, leading to increased mitochondrial membrane potential, decreased mitochondrial oxidative stress, and reduced apoptosis in senescent cardiomyocytes, whereas Shank3 overexpression mimicked D-gal-induced mitophagy inhibition and mitochondrial dysfunction in normally cultured cardiomyocytes. Mechanistically, the IP assay revealed that Shank3 directly binds to CaMKII, and this interaction was further increased in the aged heart. Enhanced Shank3/CaMKII binding impedes mitochondrial translocation of CaMKII, resulting in the inhibition of parkin-mediated mitophagy, which ultimately leads to mitochondrial dysfunction and cardiac damage in the aged heart. Our study identified Shank3 as a novel contributor to aging-related cardiac damage. Manipulating Shank3/CaMKII-induced mitophagy inhibition could thus be an optional strategy for therapeutic intervention in clinical aging-related cardiac dysfunctions.
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Affiliation(s)
- Ying Wang
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Yuerong Xu
- Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi’an, 710032, China
| | - Wangang Guo
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Yexian Fang
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Lang Hu
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Runze Wang
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Ran Zhao
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Dong Guo
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Bingchao Qi
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Gaotong Ren
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China
| | - Jun Ren
- Department of Cardiology and Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China,Corresponding author. Department of Cardiology and Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Yan Li
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China,Corresponding author.
| | - Mingming Zhang
- Department of Cardiology, Tangdu Hospital, Air Force Medical University, Xi’an, 710038, China,Corresponding author.
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6
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Zhang J, Fang Y, Yao Y, Zhao Y, Yue D, Sung M, Jin Y, Zheng ZJ. Disparities in cardiovascular disease prevalence among middle-aged and older adults: Roles of socioeconomic position, social connection, and behavioral and physiological risk factors. Front Cardiovasc Med 2022; 9:972683. [PMID: 36312247 PMCID: PMC9614039 DOI: 10.3389/fcvm.2022.972683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/26/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Cardiovascular disease (CVD) remains the leading cause of premature death globally and a major contributor to decreasing quality of life. In the present study, we investigated the contribution of social, behavioral, and physiological determinants of CVD and their different patterns among middle-aged and older adults. Methods We used harmonized data from 6 nationally representative individual-level longitudinal studies across 25 countries. We restricted the age to ≥50 years and defined cases as a self-reported history of CVD. The exposure variables were the demographic status (age and sex), socioeconomic position (education level, employment, and household income level), social connections (marital status and family size), behavioral factors (smoking, alcohol drinking, and frequency of moderate to vigorous physical activity), and physiological risk factors (obesity, presence of hypertension, and presence of diabetes). Mixed logistic regression models were fitted to investigate the associations, and dominance analysis was conducted to examine the relative contributions. Results In total, 413,203 observations were included in the final analysis, with the CVD prevalence ranging from 10.4% in Mexico to 28.8% in the United States. Physiological risk factors were the main driver of CVD prevalence with the highest dominance proportion, which was higher in developing countries (China, 57.5%; Mexico, 72.8%) than in developed regions (United States, England, 10 European countries, and South Korea). Socioeconomic position and behavioral factors also highly contributed but were less significant in developing countries than in developed regions. The relative contribution of socioeconomic position ranged from 9.4% in Mexico to 23.4% in the United States, and that of behavioral factors ranged from 5.7% in Mexico to 26.1% in England. Conclusion The present study demonstrated the different patterns of determinant contributions to CVD prevalence across developing and developed countries. With the challenges produced by different risk factors, the implementation of tailored prevention and control strategies will likely narrow disparities in the CVD prevalence by promoting health management and enhancing the capacity of health systems across different countries.
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Affiliation(s)
- Ji Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Yian Fang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yang Zhao
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia,The George Institute for Global Health China, Beijing, China
| | - Dahai Yue
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, United States
| | | | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China,Institute for Global Health and Development, Peking University, Beijing, China,*Correspondence: Yinzi Jin
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China,Institute for Global Health and Development, Peking University, Beijing, China,Zhi-Jie Zheng
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Díaz-Vesga MC, Zúñiga-Cuevas Ú, Ramírez-Reyes A, Herrera-Zelada N, Palomo I, Bravo-Sagua R, Riquelme JA. Potential Therapies to Protect the Aging Heart Against Ischemia/Reperfusion Injury. Front Cardiovasc Med 2021; 8:770421. [PMID: 34869687 PMCID: PMC8639870 DOI: 10.3389/fcvm.2021.770421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022] Open
Abstract
Despite important advances in the treatment of myocardial infarction that have significantly reduced mortality, there is still an unmet need to limit the infarct size after reperfusion injury in order to prevent the onset and severity of heart failure. Multiple cardioprotective maneuvers, therapeutic targets, peptides and drugs have been developed to effectively protect the myocardium from reperfusion-induced cell death in preclinical studies. Nonetheless, the translation of these therapies from laboratory to clinical contexts has been quite challenging. Comorbidities, comedications or inadequate ischemia/reperfusion experimental models are clearly identified variables that need to be accounted for in order to achieve effective cardioprotection studies. The aging heart is characterized by altered proteostasis, DNA instability, epigenetic changes, among others. A vast number of studies has shown that multiple therapeutic strategies, such as ischemic conditioning phenomena and protective drugs are unable to protect the aged heart from myocardial infarction. In this Mini-Review, we will provide an updated state of the art concerning potential new cardioprotective strategies targeting the aging heart.
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Affiliation(s)
- Magda C Díaz-Vesga
- Programa de Fisiología y Biofísica, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Grupo de Investigación en Ciencias Básicas y Clínicas de la Salud, Pontificia Universidad Javeriana de Cali, Cali, Colombia.,Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Úrsula Zúñiga-Cuevas
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andrés Ramírez-Reyes
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Nicolas Herrera-Zelada
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Iván Palomo
- Thrombosis Research Center, Faculty of Health Sciences, Universidad de Talca, Talca, Chile.,Interuniversity Center for Healthy Aging, Chile
| | - Roberto Bravo-Sagua
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Interuniversity Center for Healthy Aging, Chile.,Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile
| | - Jaime A Riquelme
- Advanced Center for Chronic Disease (ACCDiS), Facultad de Ciencias Químicas y Farmacéuticas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Interuniversity Center for Healthy Aging, Chile
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8
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Ellis AC, Mehta T, Nagabooshanam VA, Dudenbostel T, Locher JL, Crowe-White KM. Daily 100% watermelon juice consumption and vascular function among postmenopausal women: A randomized controlled trial. Nutr Metab Cardiovasc Dis 2021; 31:2959-2968. [PMID: 34344546 PMCID: PMC8435004 DOI: 10.1016/j.numecd.2021.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Watermelon juice is a rich food source of cardioprotective compounds such as arginine, citrulline, and lycopene. Preventative interventions are warranted as risk of cardiovascular disease increases among women after menopause, and age alone is an independent risk factor for vascular dysfunction. Thus, this study evaluated the effects of 100% watermelon juice on measures of vascular function. METHODS AND RESULTS In this randomized, double-blind, placebo-controlled, crossover trial, 21 healthy postmenopausal women were randomized to consume two 360 mL servings of 100% watermelon juice per day or an isocaloric placebo for four weeks. Following a two-week washout period, they consumed the other beverage for an additional four weeks. Before and after each treatment arm, a fasting blood sample was taken for measurement of serum arginine, citrulline, lycopene, glucose, and insulin. Assessments of vascular function included pulse pressure, pulse wave velocity, 24-h ambulatory blood pressure, and flow-mediated dilation. General linear mixed models with intent-to-treat analyses were used to examine the effects of the intervention. Despite a significant treatment effect for circulating lycopene (p = 0.002), no changes in arginine, citrulline, or any vascular measures were observed. Although the juice intervention resulted in a slight but significant increase in fasting serum glucose (p = 0.001), changes in glucose homeostasis were not clinically significant. CONCLUSION In contrast to findings from previous studies in younger adults and those with pre-existing hypertension, measures of vascular function in this cohort of healthy postmenopausal women were not impacted by supplemental watermelon juice. CLINICALTRIALS. GOV IDENTIFIER NCT03626168.
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Affiliation(s)
- Amy C Ellis
- University of Alabama, Department of Human Nutrition, Russell Hall, Box 870311, Tuscaloosa, AL, 35487, USA.
| | - Tapan Mehta
- University of Alabama at Birmingham, Nutrition Obesity Research Center, 1675 University Blvd, Birmingham, AL, 35294, USA.
| | - Vinoth A Nagabooshanam
- University of Alabama at Birmingham, UAB/Lakeshore Foundation Research Collaborative, 1675 University Blvd, Birmingham, AL, 35294, USA.
| | - Tanja Dudenbostel
- University of Alabama at Birmingham, Cardiovascular Disease, Vascular Biology & Hypertension, 933 19th Street South, Birmingham, AL 35294, USA.
| | - Julie L Locher
- University of Alabama at Birmingham, Division of Gerontology, Geriatrics, and Palliative Care, 933 19th Street South, Birmingham, AL 35294, USA.
| | - Kristi M Crowe-White
- University of Alabama, Department of Human Nutrition, Russell Hall, Box 870311, Tuscaloosa, AL, 35487, USA.
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9
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Rao Z, Hua J, Li R, Fu Y, Li J, Xiao W, He J, Hu G. Changes in Six-Month Prevalence of Circulatory System Diseases among People Aged 20 Years and Older between 2013 and 2018 in Hunan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052599. [PMID: 33807674 PMCID: PMC7967526 DOI: 10.3390/ijerph18052599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 11/30/2022]
Abstract
Recent changes in population-based prevalence for circulatory system diseases (CSDs) remain unreported either nationally or locally for China. Data were from the two-round health service household interview survey of Hunan Province, China, in 2013 and 2018. A Rao–Scott chi-square test was performed to examine prevalence differences across socio-demographic variables. The overall age-standardized prevalence of CSDs increased substantially between 2013 and 2018 for inhabitants aged 20 years and older (14.25% vs. 21.25%; adjusted odds ratio (OR) = 1.59, 95% CI: 1.24–2.04). Hypertensive disease was the most prevalent type of CSD, accounting for 87.24% and 83.83% of all CSDs in 2013 and in 2018, respectively. After controlling for other socio-demographic factors, the prevalence of CSDs was significantly higher in 2018 (adjusted OR = 1.40), urban residents (adjusted OR = 1.43), females (adjusted OR = 1.12) and older age groups (adjusted OR = 5.36 for 50–59 years, 9.51 for 60–69 years, 15.19 for 70–79 years, and 12.90 for 80 years and older) than in 2013, rural residents, males and the youngest age group (20–49 years). The recent increase in the overall age-standardized CSD prevalence and the large prevalence disparities across urban/rural residents, sex and age groups merit the attention of policymakers and researchers. Further prevention efforts are needed to curb the increasing tendency and to reduce the prevalence of disparities across socio-demographic groups.
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Affiliation(s)
| | | | | | | | | | | | | | - Guoqing Hu
- Correspondence: ; Tel.: +86-0731-84805414
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Ischemic Heart Disease Pathophysiology Paradigms Overview: From Plaque Activation to Microvascular Dysfunction. Int J Mol Sci 2020; 21:ijms21218118. [PMID: 33143256 PMCID: PMC7663258 DOI: 10.3390/ijms21218118] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023] Open
Abstract
Ischemic heart disease still represents a large burden on individuals and health care resources worldwide. By conventions, it is equated with atherosclerotic plaque due to flow-limiting obstruction in large-medium sized coronary arteries. However, clinical, angiographic and autoptic findings suggest a multifaceted pathophysiology for ischemic heart disease and just some cases are caused by severe or complicated atherosclerotic plaques. Currently there is no well-defined assessment of ischemic heart disease pathophysiology that satisfies all the observations and sometimes the underlying mechanism to everyday ischemic heart disease ward cases is misleading. In order to better examine this complicated disease and to provide future perspectives, it is important to know and analyze the pathophysiological mechanisms that underline it, because ischemic heart disease is not always determined by atherosclerotic plaque complication. Therefore, in order to have a more complete comprehension of ischemic heart disease we propose an overview of the available pathophysiological paradigms, from plaque activation to microvascular dysfunction.
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11
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Thomas MC, Iyngkaran P. Forensic interrogation of diabetic endothelitis in cardiovascular diseases and clinical translation in heart failure. World J Cardiol 2020; 12:409-418. [PMID: 32879703 PMCID: PMC7439453 DOI: 10.4330/wjc.v12.i8.409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/05/2020] [Accepted: 07/19/2020] [Indexed: 02/06/2023] Open
Abstract
Diabetic heart disease (DHD) can be classified as a primary consequence from several pathophysiological manifestation of diabetes mellitus (DM) on cardiac tissues or secondarily in extracardiac tissues and is encountered as either primary or secondary complications of DM. Endothelitis is inflammation of the vascular endothelium and is likely to be seen in the majority of patients who start to manifest an end organ complication of DM in this case DHD. Diabetes is a leading cause for many cardiovascular syndromes and diseases including congestive heart failure (CHF) however much remains unknown about the transition from diagnosed DM to clinical state and the contribution of the various mechanical and counterregulatory systems in the manifested complaint. Diastolic heart failure or heart failure with preserved ejection fraction (DHF/HFpEF), accounts for half of all CHF presentations, has DM as a major contributor, however, there remain large gaps in clinical and pathophysiological understanding. This review aims to explore the microscopic aspects in diabetic endothelitis and provide a clinical link to with context to HFpEF.
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Affiliation(s)
- Merlin C Thomas
- Department of Diabetes, Monash University, Melbourne 3004, Victoria, Australia
| | - Pupalan Iyngkaran
- Werribee Mercy Sub School, School of Medicine Sydney, University of Notre Dame, Northcote 3070, Victoria, Australia
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12
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Liu Z, Xu G, Xu L, Zhang Y, Huang Y. Perioperative Cardiac Complications in Patients Over 80 Years of Age with Coronary Artery Disease Undergoing Noncardiac Surgery: The Incidence and Risk Factors. Clin Interv Aging 2020; 15:1181-1191. [PMID: 32801670 PMCID: PMC7398882 DOI: 10.2147/cia.s252160] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/26/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Ever-increasing noncardiac surgeries are performed in patients aged 80 years or over with coronary artery disease (CAD). The objective of the study was to explore the incidence and risk factors of perioperative cardiac complications (PCCs) for the oldest-old patients with CAD undergoing noncardiac surgery, which have not been evaluated previously. Patients and Methods A total of 547 patients, aged over 80 years, with a history of CAD who underwent noncardiac surgery were enrolled in this retrospective study. Perioperative clinical variables were extracted from the electronic medical records database. The primary outcome was the occurrence of PCCs intraoperatively or within 30 days postoperatively, defined as any of the following complications: acute coronary syndrome, heart failure, new-onset severe arrhythmia, nonfatal cardiac arrest, and cardiac death. Multivariate logistic regression analysis and multivariate Cox regression model were both performed to estimate the risk factors of PCCs. The incidence of PCCs overtime was illustrated by the Kaplan-Meier curve with a stratified Log-rank test. Results One hundred six (19.4%) patients developed at least one PCC, and 15 (2.7%) patients developed cardiac death. The independent risk factors contributing to PCCs were age ≧85 years; body mass index ≧30 kg/m2; the history of angina within 6 months; metabolic equivalents <4; hypertension without regular treatment; preoperative ST-T segment abnormality; anesthesia time >3 h and drainage ≧200 mL within 24 h postoperatively. Conclusion The incidence of PCCs in elderly patients over 80 years with CAD who underwent noncardiac surgery was high. Comprehensive preoperative evaluation, skilled surgical technique, and regular postoperative monitoring may help to reduce the occurrence of PCCs in this high-risk population.
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Affiliation(s)
- Zijia Liu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People's Republic of China
| | - Guangyan Xu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People's Republic of China
| | - Li Xu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People's Republic of China
| | - Yuelun Zhang
- Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People's Republic of China
| | - Yuguang Huang
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People's Republic of China
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13
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Morici N, Molinari V, Cantoni S, Rubboli A, Antolini L, Sacco A, Cattaneo M, Alicandro G, Oreglia JA, Oliva F, Giannattasio C, Brunelli D, La Vecchia C, Valgimigli M, Savonitto S. Long-Term Risk of Major Adverse Cardiovascular Events in Patients With Acute Coronary Syndrome: Prognostic Role of Complete Blood Cell Count. Angiology 2020; 71:831-839. [PMID: 32638621 DOI: 10.1177/0003319720938619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individual parameters of complete blood count (CBC) have been associated with worse outcome in patients with acute coronary syndrome (ACS). However, the prognostic role of CBC taken as a whole has never been evaluated for long-term incidence of major adverse cardiovascular events (MACEs). Patients were grouped according to their hematopoietic cells' inflammatory response at different time points during hospital stay. Patients with admission white blood cell count >10 × 109/L, discharge hemoglobin <120 g/L, and discharge platelet count >250 × 109/L were defined as "high-risk CBC." Among 1076 patients with ACS discharged alive, 129 (12%) had a "high-risk CBC" and 947 (88%) had a "low-risk CBC." Patients with "high-risk CBC" were older and had more comorbidities. Over a median follow-up of 665 days, they experienced a higher incidence of MACE compared to "low-risk CBC" patients (18.6% vs 8.1%). After adjustment for age, age-adjusted Charlson comorbidity index, female sex, cardiac arrest, suboptimal discharge therapy, coronary artery bypass, and ejection fraction, a high-risk CBC was significantly associated with increased MACE occurrence (adjusted hazard ratio 1.80; 95% CI: 1.09-3.00). The CBC was a prognostic marker in patients with ACS, and its evaluation at admission and discharge could better classify patient's risk and improve therapeutic management.
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Affiliation(s)
- Nuccia Morici
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.,Department of Clinical Sciences and Community Health, 9305Università degli Studi di Milano, Milan, Italy
| | | | - Silvia Cantoni
- Hematology Department, 9338ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Andrea Rubboli
- Division of Cardiology, Department of Cardiovascular Diseases, AUSL Romagna, Ospedale S. Maria delle Croci, Ravenna, Italy
| | - Laura Antolini
- School of Medicine, Center of Biostatistics for Clinical Epidemiology, University of Milano-Bicocca, Monza, Italy
| | - Alice Sacco
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Cattaneo
- Dipartimento di Scienze della Salute, 9304Università Degli Studi di Milano, Milan, Italy.,Unità di Medicina 2, ASST Santi Paolo e Carlo, Milan, Italy
| | - Gianfranco Alicandro
- Department of Clinical Sciences and Community Health, 9305Università degli Studi di Milano, Milan, Italy.,18354Italian National Institute of Statistics, Rome, Italy
| | - Jacopo A Oreglia
- Interventional Cardiology Division and De Gasperis Cardio Center, 9338ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Fabrizio Oliva
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.,Interventional Cardiology Division and De Gasperis Cardio Center, 9338ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Cristina Giannattasio
- School of Medicine, University Milano Bicocca, Monza, Italy.,Cardiologia 4 and De Gasperis Cardio Center, 9338ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Dario Brunelli
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, 9305Università degli Studi di Milano, Milan, Italy
| | - Marco Valgimigli
- Department of Cardiology, University Hospital of Bern, Bern, Switzerland
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14
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Etienne J, Liu C, Skinner CM, Conboy MJ, Conboy IM. Skeletal muscle as an experimental model of choice to study tissue aging and rejuvenation. Skelet Muscle 2020; 10:4. [PMID: 32033591 PMCID: PMC7007696 DOI: 10.1186/s13395-020-0222-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 01/12/2020] [Indexed: 12/16/2022] Open
Abstract
Skeletal muscle is among the most age-sensitive tissues in mammal organisms. Significant changes in its resident stem cells (i.e., satellite cells, SCs), differentiated cells (i.e., myofibers), and extracellular matrix cause a decline in tissue homeostasis, function, and regenerative capacity. Based on the conservation of aging across tissues and taking advantage of the relatively well-characterization of the myofibers and associated SCs, skeletal muscle emerged as an experimental system to study the decline in function and maintenance of old tissues and to explore rejuvenation strategies. In this review, we summarize the approaches for understanding the aging process and for assaying the success of rejuvenation that use skeletal muscle as the experimental system of choice. We further discuss (and exemplify with studies of skeletal muscle) how conflicting results might be due to variations in the techniques of stem cell isolation, differences in the assays of functional rejuvenation, or deciding on the numbers of replicates and experimental cohorts.
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Affiliation(s)
- Jessy Etienne
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, Berkeley, CA, 94720-3220, USA
| | - Chao Liu
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, Berkeley, CA, 94720-3220, USA
| | - Colin M Skinner
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, Berkeley, CA, 94720-3220, USA
| | - Michael J Conboy
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, Berkeley, CA, 94720-3220, USA
| | - Irina M Conboy
- Department of Bioengineering and QB3 Institute, University of California, Berkeley, Berkeley, CA, 94720-3220, USA.
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15
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Hsu BG, Chen TK, Pan YC, Wang CH, Hou JS. Low serum adiponectin level is associated with central arterial stiffness in patients undergoing peritoneal dialysis. Tzu Chi Med J 2020; 32:272-277. [PMID: 32955506 PMCID: PMC7485669 DOI: 10.4103/tcmj.tcmj_67_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/29/2019] [Accepted: 06/11/2019] [Indexed: 11/18/2022] Open
Abstract
Objective: Adiponectin has antidiabetic, anti-atherosclerotic, and anti-inflammatory functions and protects against vascular damage. Carotid-femoral pulse wave velocity (cfPWV) is a noninvasive method for measuring central artery stiffness, which is known to be associated with cardiovascular disease in peritoneal dialysis (PD) patients. This study was conducted to evaluate the relationship between central arterial stiffness and serum adiponectin levels in PD patients. Materials and Methods: Fasting blood samples were obtained from 60 PD patients, and the cfPWV value was measured using a validated tonometry system. In this study, cfPWV values of >10 m/s were used to define the high arterial stiffness group according to the European Society of Hypertension and the European Society of Cardiology guidelines. Results: Among 60 patients with PD, 19 patients (31.7%) were included in the high arterial stiffness group. When compared to those in the control group, the high arterial stiffness group patients were older (P = 0.029), had longer PD vintage (P = 0.001), higher diastolic blood pressures (P = 0.030), higher fasting glucose (P = 0.014), and lower serum adiponectin levels (P = 0.001). After multivariable logistic regression analysis, serum adiponectin (odds ratio, 0.612; 95% confidence interval: 0.426–0.879; P = 0.008) was identified as an independent predictor of arterial stiffness. The multivariable regression analysis also showed that the adiponectin level (β = −0.408; adjusted R2 change = 0.183; P < 0.001) was negatively associated with cfPWV values in patients undergoing PD. Conclusion: Low serum adiponectin level is an independent marker of arterial stiffness in patients undergoing PD.
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16
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Zhao ZA, Han X, Lei W, Li J, Yang Z, Wu J, Yao M, Lu XA, He L, Chen Y, Zhou B, Hu S. Lack of Cardiac Improvement After Cardiosphere-Derived Cell Transplantation in Aging Mouse Hearts. Circ Res 2019; 123:e21-e31. [PMID: 30359191 DOI: 10.1161/circresaha.118.313005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
RATIONALE Aging is one of the most significant risk factors for cardiovascular diseases, and the incidence of myocardial ischemia increases dramatically with age. Some studies have reported that cardiosphere-derived cells (CDCs) could benefit the injured heart. Nevertheless, the convincing evidence on CDC-induced improvement of aging heart is still limited. OBJECTIVE In this study, we tested whether the CDCs isolated from neonatal mice could benefit cardiac function in aging mice. METHODS AND RESULTS We evaluated cardiac function of PBS- (n=15) and CDC-injected (n=19) aging mice. Echocardiography indicated that left ventricular (LV) ejection fraction (57.46%±3.57% versus 57.86%±2.44%) and LV fraction shortening (30.67%±2.41% versus 30.51%±1.78%) showed similar values in PBS- and CDC-injected mice. The diastolic wall thickness of LV was significantly increased after CDC injection, resulting in reduced diastolic LV volume. The pulse-wave Doppler and tissue Doppler imaging indicated that aging mice receiving PBS or CDC injection presented similar values of the peak early transmitral flow velocity, the peak late transmitral flow velocity, the ratio of the peak early transmitral flow velocity to the peak late transmitral flow velocity, and the ratio of the peak early transmitral flow velocity to the peak early diastolic mitral annular velocity, respectively. Pressure-volume loop experiment indicated that the LV end-diastolic pressure-volume relationship and end-systolic pressure-volume relationship were comparable in both PBS- and CDC-injected mice. Postmortem analysis of aging mouse hearts showed similar fibrotic degree in the 2 groups. In addition, the aging markers showed comparable expression levels in both PBS- and CDC-injected mice. The systemic aging performance measures, including exercise capacity, hair regrowth capacity, and inflammation, showed no significant improvement in CDC-injected mice. Finally, the telomere length was comparable between PBS- and CDC-injected mice. CONCLUSIONS Together, these results indicate that CDCs do not improve heart function and systemic performances in aging mice.
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Affiliation(s)
- Zhen-Ao Zhao
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China.,Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Medical College (Z.-A.Z., X.H., W.L., J.L., Y.C., S.H.), Soochow University, Suzhou, China
| | - Xinglong Han
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China.,Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Medical College (Z.-A.Z., X.H., W.L., J.L., Y.C., S.H.), Soochow University, Suzhou, China
| | - Wei Lei
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China.,Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Medical College (Z.-A.Z., X.H., W.L., J.L., Y.C., S.H.), Soochow University, Suzhou, China
| | - Jingjing Li
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China.,Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Medical College (Z.-A.Z., X.H., W.L., J.L., Y.C., S.H.), Soochow University, Suzhou, China
| | - Zhuangzhuang Yang
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China
| | - Jie Wu
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China
| | - Mengchao Yao
- School of Life Science, Shanghai University, China (M.Y.)
| | - Xing-Ai Lu
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China
| | - Lingjuan He
- the State Key Laboratory of Cell Biology, CAS Center for Excellence on Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences (L.H., B.Z.)
| | - Yihuan Chen
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China.,Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Medical College (Z.-A.Z., X.H., W.L., J.L., Y.C., S.H.), Soochow University, Suzhou, China
| | - Bin Zhou
- the State Key Laboratory of Cell Biology, CAS Center for Excellence on Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences (L.H., B.Z.)
| | - Shijun Hu
- From the Institute for Cardiovascular Science and Department of Cardiovascular Surgery of the First Affiliated Hospital, Medical College (Z.-A.Z., X.H., W.L., J.L., Z.Y., J.W., X.-A.L., Y.C., S.H.), Soochow University, Suzhou, China.,Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Medical College (Z.-A.Z., X.H., W.L., J.L., Y.C., S.H.), Soochow University, Suzhou, China
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A New Functional Classification Based on Frailty and Disability Stratifies the Risk for Mortality Among Older Adults: The FRADEA Study. J Am Med Dir Assoc 2019; 20:1105-1110. [PMID: 30853426 DOI: 10.1016/j.jamda.2019.01.129] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The aim of the current study was to investigate whether a new functional classification, based on basic (BADL) and instrumental (IADL) activities of daily living and frailty, is associated with mortality in older adults during 10 years of follow-up. DESIGN Cohort study, with a follow-up of 10 years. SETTING AND PARTICIPANTS A total of 924 participants aged 70 and older from the Frailty and Dependence in Albacete (FRADEA) study, a population-based sample of Spanish older adults. MEASURES At baseline, a new functional classification of 8 categories was constructed with limitations in BADL using the Barthel Index, limitations in IADL using the Lawton IADL Index, and the criteria of the frailty phenotype. Associations with 10-year mortality were assessed using Kaplan-Meier curves and Cox proportional hazard models. RESULTS The risk of mortality gradually increased toward the less functionally independent end of the classification. The presence of mild, moderate, or severe BADL impairment was associated with mortality, in models adjusted for age, sex, comorbidity and institutionalization. The analyses also revealed that those who were BADL independent, IADL dependent and prefrail [hazard ratio (HR) = 2.27, 95% confidence interval (CI) = 1.22-4.20], and those who were BADL independent and frail (HR = 3.74, 95% CI = 1.88-7.42) had an increased risk of mortality. CONCLUSIONS/IMPLICATIONS A new functional classification composed of BADL, IADL, and frailty representing the functional continuum is effective in stratifying the risk for mortality in older adults. Frailty is a high-mortality-risk state close to subjects with mild disability in BADL, needing an intensive specialized approach. Prefrailty with any impairment in IADL has an intermediate mortality risk and should be offered primary care interventions.
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18
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Beale AL, Nanayakkara S, Segan L, Mariani JA, Maeder MT, van Empel V, Vizi D, Evans S, Lam CS, Kaye DM. Sex Differences in Heart Failure With Preserved Ejection Fraction Pathophysiology. JACC-HEART FAILURE 2019; 7:239-249. [DOI: 10.1016/j.jchf.2019.01.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 12/19/2022]
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19
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Guedeney P, Sorrentino S, Claessen B, Mehran R. The link between anemia and adverse outcomes in patients with acute coronary syndrome. Expert Rev Cardiovasc Ther 2019; 17:151-159. [DOI: 10.1080/14779072.2019.1575729] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Paul Guedeney
- The Zena and Michael A. Weiner Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, New York, USA
- Institut de Cardiologie, Sorbonne Université, ACTION Study group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
| | - Sabato Sorrentino
- The Zena and Michael A. Weiner Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, New York, USA
- Division of cardiology, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy
| | - Bimmer Claessen
- The Zena and Michael A. Weiner Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, New York, USA
| | - Roxana Mehran
- The Zena and Michael A. Weiner Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, New York, USA
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20
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Suwal A, Hao JL, Liu XF, Zhou DD, Pant OP, Gao Y, Hui P, Dai XX, Lu CW. NONRATT021972 long-noncoding RNA: A promising lncRNA in diabetes-related diseases. Int J Med Sci 2019; 16:902-908. [PMID: 31337964 PMCID: PMC6643109 DOI: 10.7150/ijms.34200] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022] Open
Abstract
Diabetes mellitus (DM) is a principal health problem with increasing incidence worldwide. It can be associated with various systemic diseases. Long non-coding RNA (lncRNA), a member of non-coding RNA has been newly linked with various human diseases. Recent evidence from animal experiments has shown that the incidence and development of type 2 diabetes are contributed by the atypical expression of lncRNA in which the biomarker with capable clinical potential was lncRNA NONRATT021972. In this review, we demonstrated the numerous functions of NONRATT021972 in different diabetes-related diseases including diabetic neuropathy, diabetic cardiac autonomic neuropathy, myocardial ischemia, and hepatic glucokinase dysfunction. The emerging evidence shows that the role of NONRATT021972 in diabetic-related disease is novel and therapeutic. These results direct us to conclude that NONRATT021972 is a potential diagnostic and future targeted therapy for diabetes-associated diseases.
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Affiliation(s)
- Abhishek Suwal
- Department of Ophthalmology, The First Hospital of Jilin University, No. 71 of Xinmin St., Changchun, Jilin Province, 130021, China
| | - Ji-Long Hao
- Department of Ophthalmology, The First Hospital of Jilin University, No. 71 of Xinmin St., Changchun, Jilin Province, 130021, China
| | - Xiu-Fen Liu
- Department of Ophthalmology, The First Hospital of Jilin University, No. 71 of Xinmin St., Changchun, Jilin Province, 130021, China
| | - Dan-Dan Zhou
- Department of Radiology, The First Hospital of Jilin University, No. 71 of Xinmin St., Changchun, Jilin Province, 130021, China
| | - Om Prakash Pant
- Department of Ophthalmology, The First Hospital of Jilin University, No. 71 of Xinmin St., Changchun, Jilin Province, 130021, China
| | - Ying Gao
- Department of Endocrinology, The First Hospital of Jilin University, No. 71 of xinmin St., Changchun, Jilin Province, 130021, China
| | - Peng Hui
- Department of Ophthalmology, The First Hospital of Jilin University, No. 71 of Xinmin St., Changchun, Jilin Province, 130021, China
| | - Xin-Xuan Dai
- Department of Ophthalmology, The First Hospital of Jilin University, No. 71 of Xinmin St., Changchun, Jilin Province, 130021, China
| | - Cheng-Wei Lu
- Department of Ophthalmology, The First Hospital of Jilin University, No. 71 of Xinmin St., Changchun, Jilin Province, 130021, China
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21
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Rogers P, Al-Aidrous S, Banya W, Haley SR, Mittal T, Kabir T, Panoulas V, Raja S, Bhudia S, Probert H, Prendergast C, Spence MS, Davies S, Moat N, Taylor RS, Dalby M. Cardiac rehabilitation to improve health-related quality of life following trans-catheter aortic valve implantation: a randomised controlled feasibility study: RECOVER-TAVI Pilot, ORCA 4, For the Optimal Restoration of Cardiac Activity Group. Pilot Feasibility Stud 2018; 4:185. [PMID: 30564436 PMCID: PMC6293531 DOI: 10.1186/s40814-018-0363-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/24/2018] [Indexed: 01/13/2023] Open
Abstract
Objectives Transcatheter aortic valve implantation (TAVI) is often undertaken in the oldest frailest cohort of patients undergoing cardiac interventions. We plan to investigate the potential benefit of cardiac rehabilitation (CR) in this vulnerable population. Design We undertook a pilot randomised trial of CR following TAVI to inform the feasibility and design of a future randomised clinical trial (RCT). Participants We screened patients undergoing TAVI at a single institution between June 2016 and February 2017. Interventions Participants were randomised post-TAVI to standard of care (control group) or standard of care plus exercise-based CR (intervention group). Outcomes We assessed recruitment and attrition rates, uptake of CR, and explored changes in 6-min walk test, Nottingham Activities of Daily Living, Fried and Edmonton Frailty scores and Hospital Anxiety and Depression Score, from baseline (30 days post TAVI) to 3 and 6 months post randomisation. We also undertook a parallel study to assess the use of the Kansas City Cardiomyopathy Questionnaire (KCCQ) in the post-TAVI population. Results Of 82 patients screened, 52 met the inclusion criteria and 27 were recruited (3 patients/month). In the intervention group, 10/13 (77%) completed the prescribed course of 6 sessions of CR (mean number of sessions attended 7.5, SD 4.25) over 6 weeks. At 6 months, all participants were retained for follow-up. There was apparent improvement in outcome scores at 3 and 6 months in control and CR groups. There were no recorded adverse events associated with the intervention of CR. The KCCQ was well accepted in 38 post-TAVI patients: mean summary score 72.6 (SD 22.6). Conclusions We have demonstrated the feasibility of recruiting post-TAVI patients into a randomised trial of CR. We will use the findings of this pilot trial to design a fully powered multicentre RCT to inform the provision of CR and support guideline development to optimise health-related quality of life outcomes in this vulnerable population. Retrospectively registered 3rd October 2016 clinicaltrials.gov NCT02921880. Trial registration Clinicaltrials.Gov identifier NCT02921880.
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Affiliation(s)
- Paula Rogers
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Sayed Al-Aidrous
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Winston Banya
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Shelley Rahman Haley
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Tarun Mittal
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Tito Kabir
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Vasileois Panoulas
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Shahzad Raja
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Sunil Bhudia
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Heather Probert
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Claire Prendergast
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | | | - Simon Davies
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Neil Moat
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
| | - Rod S Taylor
- 3Institute of Health Research, University of Exeter Medical School, Exeter & The School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | - Miles Dalby
- 1Royal Brompton & Harefield NHS Foundation Trust London, Imperial College, London, UK.,2Royal Victoria Hospital, Belfast, UK
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22
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Costa D, Aladio M, Girado CA, Pérez de la Hoz R, Sara Berensztein C. Frailty is independently associated with 1-year mortality after hospitalization for acute heart failure. IJC HEART & VASCULATURE 2018; 21:103-106. [PMID: 30450408 PMCID: PMC6226571 DOI: 10.1016/j.ijcha.2018.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/07/2018] [Accepted: 10/10/2018] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Frailty is a complex condition that results from the loss of physiological reserve across multiple systems. Its presence should be considered in the aging heart failure population, since it is an important predictor of death and institutionalization in the elderly. METHODS AND RESULTS In a prospective, observational and analytical single-center study of 100 elderly patients hospitalized for acute heart failure, we assessed the characteristics associated with an increased hospital and 1-year mortality. Frailty was evaluated with the Clinical Frailty Scale, and there was a significant association between its presence and 1-year mortality (RR = 2.03; 95% CI = 1.18-3.48; p = 0.014), although not with in-hospital mortality. After adjusting for probable confounders, it remained independently associated with 1-year mortality. CONCLUSION Frailty can be assessed with a simple bed-side scale and provides significant prognostic information in acute heart failure patients.
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Affiliation(s)
- Diego Costa
- Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Argentina
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23
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Somogyi V, Peto K, Deak A, Tanczos B, Nemeth N. Effects of aging and gender on micro-rheology of blood in 3 to 18 months old male and female Wistar (Crl:WI) rats. Biorheology 2018; 54:127-140. [PMID: 29562483 DOI: 10.3233/bir-17148] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Age- and gender-related alterations of hemorheological parameters have not been completely elucidated to date. Experiments on older animals may give valuable information on this issue. However, the majority of rheological studies have been performed in young rodents. OBJECTIVE We aimed to investigate the influence of aging and gender on hemorheological parameters in rats. METHODS Coeval male (n=10) and female (n=10) Wistar (Crl:WI) rats were followed-up over 15 months. Blood samples were obtained from the lateral tail vein at 3, 4, 5, 9, 12, 15 and 18 months of age. Hematological parameters, red blood cell deformability (elongation under shear), osmotic gradient deformability and erythrocyte aggregation were tested. Body weight and the estrus cycle (in females) were also examined. RESULTS Erythrocyte aggregation showed age- and gender-related variations. Red blood cell deformability was greater in females and gradually decreased over the 15-month period in both genders. Erythrocyte aggregation was greater in male rats at most ages, but did not show consistent changes with age. CONCLUSIONS The micro-rheological parameters showed age-related alterations with gender differences. The effect of the estrous cycle cannot be excluded in female rats. The results provide reference data for studies of aging in rats and of the mechanism related to age and gender differences in hemorheology.
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Affiliation(s)
- Viktoria Somogyi
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Hungary
| | - Katalin Peto
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Hungary
| | - Adam Deak
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Hungary
| | - Bence Tanczos
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Hungary
| | - Norbert Nemeth
- Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Hungary
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24
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Nanayakkara S, Patel HC, Kaye DM. Hospitalisation in Patients With Heart Failure With Preserved Ejection Fraction. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2018; 12:1179546817751609. [PMID: 29343997 PMCID: PMC5764137 DOI: 10.1177/1179546817751609] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 12/07/2017] [Indexed: 12/16/2022]
Abstract
Heart failure is highly prevalent with more than 50% of cases being patients with a preserved ejection fraction (HFPEF), a figure that is projected to increase due to the changing risk factor landscape, in particular the ageing population. Overall mortality is similar to patients with heart failure with reduced ejection fraction (HFREF), as are the rates of hospitalisation. Patients with HFPEF have more comorbid conditions with fewer therapeutic options available. In this review, we explore the epidemiology of hospitalisation of HFPEF, the impact of current treatment modalities, and the potential of future therapies.
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Affiliation(s)
- Shane Nanayakkara
- Department of Cardiovascular Medicine, The Alfred Hospital and Baker Heart & Diabetes Institute, Melbourne, VIC, Australia.,Department of Cardiovascular Medicine, The Alfred Hospital, Melbourne, VIC, Australia
| | - Hitesh C Patel
- Department of Cardiovascular Medicine, The Alfred Hospital and Baker Heart & Diabetes Institute, Melbourne, VIC, Australia
| | - David M Kaye
- Department of Cardiovascular Medicine, The Alfred Hospital and Baker Heart & Diabetes Institute, Melbourne, VIC, Australia
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